HomeMy WebLinkAbout1986-09-04 App. & Permit, New Residence-2Pgs #6139(A ITS' of OIts NO )
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66, CRYSTAL BAY, MN 55323
ZONING DISTRICT
/R 'r s
FIRE DEPiTMENT
POST OFFICE
VAR. DATE
COND. USE DATE
LOTAREA
c
wibT4 D PTH
PROPOSED SETBACKS:
FRONT R. SIDF
i
REAR__ L. SIDE
LAKE WETLANDS
ACCESS
NEW TIN
AGENCY-APPRO . TE
Y -
COUNTY
STATE
PRIVATE EASEMENT
REMARKS
PERMIT NO. 6139'
DATE ISSUED -�
SITE ADDRESS L 11 %/ (' / t� U _
PROPERTY IDENTIFICATION NO (PID) — 7 - c-9 Z
LOT/BLOCK � — SUBDIVISION
OWNER (Name) (Address) y 7.]_L/r 7
(Phone)
079
ARCHITECT/ENGINEER - Must Certify Multi -Family. Commercia. & Industri I Construction Plans
(Firm) (Address) (Phone)
BUILDER (Firm) (Address) (Phone!
G
TYPE OF WQ14K , New J Addition Remodel Renovate
r�
CONST TYP
BUILDING SIZE
OCCUPANCY
CLASSIFICATION
DWELL
STORIES QB
UNITS
�--
W �S Ht
1 l 2 3
ALLS NUMBER OF BEDRSOMS
GS
+� J
DET. o•C SEPTIC
1APP DATE
PROPOSED USE
COUNCIL
APP DATE
Estimated Construction Valuation
' PERMIT FEES
BLDG. PERMIT
(
/ 7 _
STATE FEE
PLAN REVIEW�_(��
SAC CHARGE
SEWER UNIT�,,vV
PARK FEE
PENALTY
OTHER
TOTAL DUE /
IWORK REQUIRING ACKNOWLEDGEMENT SEPARATE PERMITS N ECTION REQUIRED
.... FOOTING before pour THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
.... FRAMING rough -in PLUMBING THE REAL IMPROVEMENTS SPECIFIED AND DECLARES
INSULATION MECHANICAL UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
...... WALLBOARD before taping p�
WE'_L ta( ANCE OF ALL IN CONDITIONS AND REQUIRE-
L ..... FINAL before occupancy
❑ ...... SITE INSPECTION SEPrIC MENTS REPRESENTED ON THIS DOCUMENT THE UNDER -
WORK BEYOND OR WITHOUT A RE- SEWER SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM-
OUIRED INSPECTION WILL BE SUB- WATER ❑ PLIANCE WI1H AL_ CITY OF ORONO ORDINANCES AND STATE
JECT TO PENALTY. OF MINNEJTn4BUILDINGREO I MENTS
GRADING d FILLING ❑ 1 I
INSPECTIONS MUST BE CALLED -IN
24 HOURS IN ADVANCE. FIRE ❑ 1 R
COPY WHITE FILE GREEN FINANCE
CANARY -INSPECTOR GOLD -RECEIPT
PINK -ASSESSOR a ....• I - C
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