HomeMy WebLinkAbout1987-06-11 Permit, Demo Residence #6405CITY of ORt )NO
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
ZONING DISTRICT
FIRE DEPARTMENT
POST OFFICE
VAR DATE
COND. ' ISE DATE
I OT AREA
4VIDTH DEPTH
PROPOSED SETB..CKS:
FRONT R. SIDE
REAR L SIDE
LAKE WETL
ACCES
NEW c (STING
AGENCY -AP V DATE
CITY
CCUNTY
STATE
PRIVATE EASEMENT COUNCIL
_
',PP. DATE S
REMARKS 1�)LA_ f1d C--1'OY1
po 1 dress� (Phone)
04-03S 7
Addition Remodel Renovate
pr i oCi / '54 rLk C t re -
Estimated Construction Valuation
FI
OCCUPANCY PERMIT FEES
CLASSIFICATIONj('�
DWELL STORIES R 2 3 BLDG. PERMII
UNITS STATE FEE
GAR STALLS NUMBER OF BEDROOMS
ATT PLAN REVIEW _
DET SEPTIC
APP. DATE
PROPOSED USE
SITE ADDRESS / / '-.Of.J
PROPERTY IDENTIFICATION NO. (PID)
LOT BLOCK
OW R . , (Name)
ARCHITECT/ENGINEER -
IFcm)
BUILDER (Firm)
.J a 5-e -4-�� n,
TYPE OF WORK _ New
PERMIT NO. 6405,
DATE ISSUED
d.
SUBnIVISiON
A — (Address) (Phone)
4
Certify Multi -Family Commercial & Industrial Construction Plans
(Address) (Phone)
NS' 'I1PE PUILDING �
L W
INSPECTION REQUIRED
WORK REQUIRING
SEPARATE PERMITS
❑ ...... FOOTING before pour
❑ ...... FRAMING fc gh-in
PLUMBING
Lj ...... INSULATION
MECHANICAt
El .... WALLBOARD before taping
WELL
..... FINAL before occupan-y
...... SITE INSPECTION
SEPTIC
WORK BEYOND OR WITHOUT A RE-
SEWER
QUIRED INSPECTION WILL Rc SUB-
WATER
JECT TO PENALTY.
GRADING 6 FILLING
INSPECTIONS MUST 3E CALLED -IN
24 HOURS IN ADVANCE
FIRE-
CUPY WHITE -FILE GREEN -FINANCE
CANARY -INSPECTOR GOLD -RECEIPT
PINK -ASSESSOR
MaMIM ►n�. aAd. fY NK Ia1a M1MI0
SAC CHARGE
SEWER UNIT
PARK FEE
PENALTY
EIS. i� I I III OTHER _ -- - -
n 70 DUE 3(j
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
U THE REAL IMPROVEMENTS SPECIFIED AND DECLARES
❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND AUCEPT-
❑ ANCE OF ALL INFORMlTION CONDITIONS AND REQUIRE-
C] MENTS REPRESENTED ON THIS DOCUMENT THS UNDER-
SIGNED FURTHER AGREES TO DO ALL WOPK IN STRICT COM-
PLIANCE WITH ALL CITY OF OROVO ORDINANCES AND STATE
❑ OF MINNE TA UILDI CODE RECUIREMENTS
❑ C
Signature Data
�*MM