HomeMy WebLinkAbout1984-09-21 App. & Permit, New Residence #5441CITVo ORONO PERMIT N;) _ 54411
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED __9 - 1 -ZL'-fEXPIRES
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
ZONING DISTRICT SITE ADDRESSFoRes't ARfhs l_AAlr _
tp,_ LEGAL DESCRIPTION. PFICP.ID. 07• 117 a3 14- gxd—"
LOT 3 BLOCK 0. St1RnI VISInN F6Cj_rt7 AiZnL c
FIRE ZONE
VAR. DATE
COND. USE DATE
LOT AREA
1 AC t
WIDTH DEPTH
't
PROPOSED SETBACKS
FRONT R.SID
REAR L.SIDE
r
LAKE WETLANDS
r
US
ACCESS
NEW XISiI1�G ~I
AGENCY -
CITY
kkm
COUNTY
STATE
PR. EASEMENT
REMARKS:
WNER
(Names
(Address)
(Phone)
7376 t4
0 C P
X 12c H
ARCHITECT/ENGINEER
Must Certify Multi
-Family, Commercial & Industrial Construction Plans
ERT.NO.
(Firm)
(Address)
(Phone)
o
cy 7_7tgosl
BUILDER
(Firm)
(Address)
(Phone)
J
TYPE OF WORK ' 75 Addition Remodel
Renovate
CONST TYPE
BLDG SIZE
EST ST VALUATION
-9:
L 7' vV 3
a
5.000
RESIDENTIAL
STOH1ES If 1 C2
PERMIT FEES
PC-_
BDRMS'FLR I S'7
FLooIle
BLDG. PERMIT
4/-70 SD
DWEL!-
UNITS (
pE'
STATE FEE
Si.
c, R STALLS
SEPTIC
jA
APP DATE A1 /
PLAN REVIEW
u Cj
PENALTY
DUCK
PARK FEE
NON RESID
PROPOSED USE
�Z G E
aieZ
OCC.
CLASS.
SA
ev2s. OGx
STORIES
COUNCIL
APP. DATE
TOTAL DUE
"V- ()
INSPECTION REQUIRED
-�_ FOOTING before pow
FRAMING rough m
INSULATION
WALLBOARD Before Tapmq
FINAL before occupancy
WORK BEYOND OR WITHOUT A RE
QUIRED INSPECTION WILL BE SUB
JECT TO PENALTY to
INSPECTION HOURS 413-1357
CALL 8 12 A M. INSP 1 4 P.M
CALL 1 4 P.M. INSP NEXT DAY
COPY WHITE FILE
CANARY INSPECTOR
PINK ASSESSOR
WORK REQUIRING
SEPARATE PERMITS
PLUMBING
MECHANICAL
WE-L __
X
SEPTIC
SEWER _
A
WATER
GRADING &
FILLING
ELECTRICAL from State
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES
UNUER 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 WORKS IN STRICT COM-
PLIANCE WITH ALL CITY O ORONO ORDINANCES AND STATE
OF MINNESOTA BUILDIN CODE R UIREMENTS.
9na/ ture Date
GREEN FINANCE
GOLD RECEIPT
Approved
"0 ' i City of Orono I