HomeMy WebLinkAbout1977-05-13 Permit, New Residence #3516APPLICATION FOR BUILDING PERMIT
AND CERTIFICATE OF OCCUPANCY
VILLAGE OF ORONO, MINNESOTA
DIRECTIONS: PER Tr1�p
SPACES NUMBERED 1 THRU 13 MUST BE FILLED IN 3 516
BEFORE PERMIT IS ISSUED (Please Print or Type)
1 SITE ADDRESS 2 DATE
SO ~l /�/ -� /3- 7 7
3. LEGAL DESCRIPTION /BL
PLAT NUMBER PARCEL NUMBER
4. OWNER I (Name) l (Address) (Tel. No I
5. ARCHITECT (Name) (Address)
i. BUILDER (Name) (Address)
7. TYPE Of WOR
i
S. SIZE OI STRUCTURE 9. NO. OF STORIES
(Haight) (WiaM) (Depth) /
1. COMPLETION DATE 12. PROPERTY DIMENSIONS
14. TYPE OF CONSTRUCTION 15 PROPERTY AREA
9D.FT
17. FRONT YARD 10 REAR YARD
- 0?00 /QO
(Tel. No.)
ITe1. No)
10. ESTIMATED COST
13. NO Of FAMILIES (If Applicable)
16. LOST AREA PER FAMILY
SO. FT.
19. SIDE YARDS
rOWiRI!
ACKNOWLEDGEMENT AND SIGNATURE:
The undersigned hereby represents upon all of the penalties of
law, for the purpose of inducing the VILLAGE OF ORONO to take
the action herein requested, that all statements herein are true
and that all work herein mentioned will be done in accordance with
the ordinance of the VILLAGE OF ORONO, the State of Minnesota,
and rulings of the Building Department.
SIGNATURE uaunven
iIue -;75--
PERMIT FEE
q� sa
STATE FEE
O&l (?/<
P6&6":F* FEE
TOTAL FEE
ZONING DISTRICT
FIRE ZONE
AGGREGATE FLOOR AREA
FLOOR AREA RATIO
MATERIAL FILE WITH
OFFSTREET PARKING
CONSTRUCTION
FOOTING
FRAMING
FINAL
CERTIFICATE OF OCCUPANCY ISSUED
DATE BY
I CITY OF ORCNO PERMIT APPLICATION
CITY USE ONLY APPLICATION INFORMATION
BUILD;NG PERMIT
No. Date- /
Inspections:
Ftg Frm
Insul WB
Final CO
SpeciT—
GENERAL PER4ITS
Type No. Date Insp.
Plmbg
Fixtures 3C
We114
Water
Meter
1weSeptic OK 3.Z.77 `�` `
Sewer
Nech.
ZWING Dist. •//j
Area OK t a •
Variance
Cond. Use
Permit Fee A? re
Plan Review Fee
State Surcharge 4p,
SAC urge %7,00 —
Total 'Due
N Z
PROJECT ADDRESS O 7 N" c)Acf
Lot 3 Bl _� Plat fX1A w,f r v�f ar
Owner c , « *' 6c c,rf .Ci
Address duo AG�e .I i e
Phone S-5- 9 -
Builder c rici_S /J !>�ckEti
Address '� c (' c>'c Eck
Phone -21.7 4-
PRINCIPAL STRUCTURE TYPE `�f''flME - Psj,✓C/f
Bsmt: Fin Area .ZaSo Unfin Area f�
Main Flr: Width Depth Area 790
2nd Flr: Width Depth Area 76,000
ACCESSORY STRUCTURE TYPE % 14ctlE
Width Depth Area fJ �U sirO
Est. Completion Date 7
Est. Construction Value*
Lot Width Depth Area 01" 4naj -f-
Lakeshore: Yes No
Wetlands: Yes No
Prop,.Setbacks: Front /Sc Rear /0 0�
Side Lake
APPLICANT 14JST SUBMIT WITH THIS FORK:
2 COPIES OF PLANS DRAMN TO SCALE, A CERTIFICATE OF
SURVEY OF THE LOT, AND THE PLAN REVIEW FEE.
The undersigned hereby makes application for a build-
ing permit for the work described, agrees to do all
work in strict accordance with the ordinances of the
City of Orono and rulings of the State Building Code
Division, and declares that all facts and represen-
tations stated herein are true and correct.
Signature
•5_ lO
Date