HomeMy WebLinkAbout1985-01-28 Application & Permit, Addition #5539CITY of nit()M)
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66. CRYSTAL BAY, MN 55323 473.7357
29
ZONING DISTRICT SITE ADDRESS
` / LEGAL DESCRIPTION: PROP. ID.,
LOf BLOCK
FIRE Zq!Y,
VAR. DATE
COND. USE DATE
LOT AREA
WIDTH DEPTH
PROPOSEE SETBACKS
FRONT R.SIDE
REAR L.SIDE
LAKE WETLANDS
S
ACCESS
NEW ISTIN
AGENCY-APPROV. DATE
CITY
COUNTY
STATE
PR. EASEMENT
REMARKS
PERMIT N° _ 55391
DATE ISSUED /�O54'a-�
EXPIRES
UBDIVISION
WNER
(Name)
(Address) (Phone)
s 7i- 9
ARCHITECT/ENGINEER — Must Certify Mufti -Family, Commercial & Industrial Construction Plans
ERT.NO.
(Firm)
(Address) (Phone)
BUILDER
(F irm)
(Address) (Phone)
71- S7/
TYPE OF WORK New
Addition model Renovate
do-62LZI
CONST TYPE
BLD', SIZE
EST�/{�CONST VALUATION
L. W
Hi �/ �O/ �oo. OO
RESIDENTIAL
STORIES B 1
2 1 PERMIT FEE ,�{{ c�-l1
BLDG. PERMIT l/• > v
DWELL.
3DRMS/FLR
Ad Q 47
UNITS
STATE FEE
GAR STALLS
SEPTIC
PLAN REVIEW
ATT
APP DATE
DET
PENALTY
DOCK
NON RESID
PROPOSED USE
PARK FEE
SAC CHARGE
OCC
CLASS
STORIES
COUNCIL
APP DATE
TOTAL DUE p�?p;),'7.!_
INSPECTION REQUIRED
-_ FOOTING before .)our
_. FRAMING rough in
INSULATION
WALLBOARD Before Tapm9
F I N A L before occupancy
WORK BEYOND OR WITHOUT A RE
QUIRED INSPECTION WILL BE SL"'
�r CT TO PENALTY.
INSPECTION HOURS 473 7357
CALL 8 12 A M. INSP 1 4 P M
CALL 1 4 P.M. INSP NEXT DAY
WORK REQUIRING
SEPARATE PERMITS
PLUMBING -
MECHANICAL
WELL _
SEPTIC.__...
SEWER----
WATER
GRADING dr FI; LING -.__..
ELECTRICAL from State
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES
UNDER PENA I TY OF LAW ACKNOWLEDGEMENT AND ACCEPT. i
ANCE OF ALL INFORMATION. CONDITIONS A.:D REQUIRE I
MENTS REPR ENTED ON THIS DOCUMENT. THE UNDER-
SIGNED FUR ER AGREES TO D L WORKS IN STRICT COM.
PLIA E ALL CITY OF O N // RDINANCES AND STATE
OF MI TA BUILOJgG� 6QUIREMENTS
� r r
Date
COPY WHITE -FILE
CANARYINSPECTOR
PINK- ASSESSOR
GREEN -FINANCE
GOLD RECEIPT
Qdo r Crty of Orono