HomeMy WebLinkAbout1987-03-30 App. & Permit, New Residence #6305CITY of OR()N(
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
ZONING ISTRIC 7
L -
FIRE DgQARTMENT
POST gFFICE
/)-) r , e
VAR. DATE
COND. USE DATE
LOT AREA
WIDTH DEPTH
o te 4 '
PROPOSED SETBACKS:
FR T R. SIDE��
REAR L. SIDE _
LAKE WETLANDS
c jj
ACCESS
NEW STING
AGENCY-APPROV. DATE
CITY
COUNTY
STATE
PRIVATE EASEMENT
REMARKS:
PERMIT NO. 6305, V
DATE ISSUED 3' 3-e0 7
SITE ADDRESS��—
PROPERTY IDENTIFICATION NO. IPIDI n 7 -7 3,1'
LOT ;-� BLOCK SUBDIVISION 't'
OWNER (Name) (Address) ;Phone��
ARCHITECT/ENGINEER Must Certify Multi -Family. Commellibal 3 lnduslriaT Construction Plans
(Firm) (Address) (Phone)
74-5221
VBUILDER (Firm) ` (Address) (Phone)
TYPE OF WORK
Remodel
Renovate
CONST. TYPE
BUILDING SIZE
Estimated Construction Valuation
A.- ra( I
L W. H I "A'
OCCUPANCY
PERMIT FEES
CLASSIFICATION
BLDG. PERMIT 3 •GL
DWELL.
STORIES B 3
UNITS
STATE FEE
3 cis
GAR. STALLS
NUMBER OF BEDROOMS
ATT. 3
PLAN REVIEW?
SEPTIC
DET.
SAC CHARGE rGv
APP. DATE �-
_�. __—___ _
Lka
PROPOSED USE
SEWER t
(i)
PARK FEE
PENALTY _
COUNCIL
ADD nerc
OTHER
INSPECTION REQUIRED
WORK REQUIRING
�..... FOOTING before pour
SEPARATE PERMITS
j r t . dill I
Q!�.... FRAMING rough-'n
PLUMBIeG ...................
�y
IU
Lk .....INSULATION
MECHANICAL....................
�y
WALLBOARD before taping
�, �•
E ...... FINAL before occupancy
WELL ..........................
... SITE INSPECTION
SEPTIC SEPTIC ......................
...
WORK BEYOND OR WITHOUT A RE-
SEWER ..................
ell
MIRED INSPECTION WILL BE SUB
WATER.
JECT TO PENALTY.
.........................
El
INSPECTIONS MUST BE CALLED -IN
GRADING & FILLING _...
24 HOURS IN ADVANCE
FIRE
COPY WHITE -FILE GREEN -FINANCE
CANARY -INSPECTOR GOLD.
OLD
RECEIPT
PINK -ASSESSOR
1010ydil,n 0116. a br Co 1- 45121 541 4470
TOTAL DUE�-
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
THE RFAL IMPROVEMENTS SPECIFIED AND DECLARES
UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT-
ANCE OF ALL INFORMATION CONDITIONS AND REQUIRE -
MINTS REPRESENTED ON THIS DOCUMENT THE UNDER-
SIGNED RTH AG4E TO DO ALL WORK IN STRICT COM-
PLIA-'dC WITH LL CI OF O NO ORDINANCES AND STATE
OF MI ESOT UILD G C EOUIREMENTS
i
S ynatur Date I ( 1
Approve City of Orono