HomeMy WebLinkAbout1985-10-01 App. & Permit, New Residence-2Pgs #5777CITY of ORO)N
Building Permit PERMIT NO. 5777,
AND APPLICATION FOR CERT!FICATE OF OCCUPANCY DATE ISSUED
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
ZONING DISTRICT SITE ADDRESS �� � L �) �--e
FIRE DEPARTM T
0. a,
roST F ICE
z
VAR.DATE
COND. USE DATE
LOT AREA _ a-C"'
. 5 4cA, c.
WIDTH I DEPTH
Q. vv
PROPOSED SETBACKS
FRONT R. SIDE
REAR L. SIDE
L AKE rr WETLANDS
$I q'("1.-
ACCESS
NEW �XISTIANTEAGENCYAPP
CITY
COUNTY
STATE
PRIVATE EASEMENT
REMARKS -
PROPERTY IDENTIFICATION NO. (PID) 'a
LOT BLOCK SUBDIVISIO y!
OWNER (Name (Address) S `1 o -K.i? (Phone)
� _mot• C�-
ARCHITECT/ENGINEER - Mus Certify III -Family, Itommercial & Industrial Construction Plans
(Firm) (Address) (Phone)
BUILDER (Firm) (Address) (Phone)
C�-
TYPE OF WORK w Addition Remodel Renovate
CONST TYPE BUILDING SIZE
W. '�j , HII;X
OCCUPANCY
CLASSIFICATION
DWELL. STORIES B (t ) 2
UNITS
GAR STALLS NUMBER OF BEDROOMS
ATT
DET. SEPTIC
APP. DATE
PROPOSED USE
ICOUNCIL
APP DATE
IN PECTION REQUIRED
WORK REQUIRING
SEPARATE PERMITS
... FOOTING before pour
.... FRAMING rough -in
PLUMBING
..... INSULATION
MECHANICAL
WALLBOARD before taping
.....FINAL before occupancy
WELL
❑ ...... SITE INSPECTION
SEPTIC
WORK BEYOND OR WITHOUT A RE-
SEWER
QUIRED INSPECTION WILL BE SUB-
JECT TO PENALTY.
WATER
INSPECTIONS MUST BE CALLED -IN
GRADING 8 FILLING
24 HOURS IN ADVANCE.
FIRE
COPY WHITE -FILE GREEN -FINANCE
CANARY -INSPECTOR GOLD.
RECEIPT
PINK -ASSESSOR
MoMrvn hy. 6 AM Cc rM I6111 U14410
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3
Estimated Construction Valuation
�` 06 (2j
PERMIT FEES
BLDG. PERMIT ___ZaS
STATE FEE _�_ �/-? - (-n
PLAN REVIEW
SAC CHARGE !_�� C)
SEWER UNIT
PARK FEE
PENALTY
OTHER
TOTAL DUE / S
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
THE REAL IMPROVEMENTS SPECIFIED AND DECLARES
UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
ANCE OF ALL INFORMATION. CONDITIONS AND REQUIRE-
MENTS REPRESENTED ON THIS DOCUMENT THE UNDER-
SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM-
PLIAN WITH ALL _CITTYY^OF O �N�i• ORDINANCES AND STATE
OF MIN F SOTA BUIL➢19G COU1fEr70IREMENTS
,Iv of Orono
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