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CITY4 ORO NO <br />Building Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPANCY <br />P.O. BOX 66. CRYSTAL BAY. MN 55323 473-7357 <br />-ONING DISTRI T <br />FIRE DEPA TMENT <br />urla <br />POST OFF( <br />Ou IZ <br />VAR. DATE <br />COND. USE DATE <br />LOT AREA <br />too s F, <br />WI(ITF1 DEPTH <br />PROPOSED SETBACKS. <br />FRONT . SIDE 4J1 <br />REAR /� L SIDE ��L-7. <br />0 4. WETLANDS <br />�s <br />LAKE <br />ACCESS <br />NEW (STING ' <br />AGENCY-APP <br />CITY <br />COUNTY <br />STATE <br />PRIVATE EASEMENT <br />REMARKS' <br />r <br />SITE ADDRESS I)y � <br />PERMIT NO. 6140 <br />DATE ISSUED <br />PROPERTY IDENTIFICATION NO (PIDI r- 1 1 - // / - crj- <br />LOT BLOCK SUBDIVISION__ <br />O R INdmei (Address) IPhonel <br />Fj ForP ;�" �M �`lz-- <br />ARCHITECT NGINBER - Must Certify Multi -Family. Commercial & Industrial Construction Pal -arms <br />IFirml (Address) (Phone) <br />BUILDER <br />IFirml <br />(Address) <br />(Phone) <br />- Y630 <br />a�� <br />TYPE OFVORK <br />New <br />Addition Remodel <br />Renovate <br />Jio . <br />CONST TYPE <br />BUILDING SIZE <br />Estimated Construction Valuation <br />L 41OQ"' W. <br />p <br />`�r Ht�8 <br />6 <br />OCCUPANCY <br />PERMIT FEES <br />CLASSIFICATION <br />BLDG. PERMIT <br />DWELL <br />STORIES B 1 2 U <br />UNITS <br />STATE FEE <br />PLAN REVIEW <br />JJ <br />STALLS <br />ATT �3 <br />NUMBER OF BEDROOMS <br />1 <br />ET <br />lc) <br />7� C'2 <br />SEPTIC <br />APP DATE <br />SAC CHARGE <br />SEWER UNIT <br />/ <br />PROPOSED USE <br />PARK FEE <br />PENALTY <br />COUNCIL <br />APP DATE <br />OTHER <br />TOTAL DUE <br />INS P TION REQUIRED <br />WORK REQUIRING <br />SEPARATE PERMITS <br />FOOTING before pour <br />f FRAMING rough -in <br />PLUMBING <br />INSULATION <br />MECHANICAL <br />WALLBOARD before taping <br />WELL <br />CI ...... FINAL before occupancy <br />Ll ...... SITE INSPECTION <br />SEPTIC <br />WORK BEYOND OR WITHOUT A RE. <br />SEWER <br />QUIRED INSPECTION WILL BE SUB. <br />JECTTO PENALTY <br />WATER <br />INSPECTIONS MUST BE CALLED -IN <br />GRADING b FILLING <br />74 HOURS IN ADVANCE <br />FIRE <br />(.' SPY wi(i t[ i it ! GRI EN FINANCF <br />CANARY INSPI l..TOH GOt D <br />RECEIPT <br />PINK -ASSESSOR <br />1100►IVn F,1& F AO* Co. la. I6121561 44IU <br />FOR <br />01 <br />ACKNOWLEDGEMENT <br />THE UNDERSIGNED HEREBY RLUUESTS PERMISSION TO MAKE <br />THE REAL IMPROVEMENTS SPECIFIED AND DECLARES <br />UNDER PENALTY OF tAW ACKNOWLEDGEMENT AND ACCEPT <br />ANCE OF ALL INFORMATION CONDITIONS AND REQUIRE. <br />MENTS REPRESENTED ON THIS DOCUMENT THE UNDER <br />SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br />PLIANCE WITH All CITY OF ORONO ORDINANCES AND STATE <br />CIF MINNESOTA BUILDINr; ,ODF REOUIREME S <br />';,gnatu,e t ,C <br />