HomeMy WebLinkAbout1985-10-09 App. & Permit, New Residence #5788CITY of ORONO
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
F
ING ISTRICTDEPARTMENT
POST OFFICE
VAR. DATE
COND. USE DATE
LOT AREA t I
WIDT 0� ", DEPTH
/
PROPOSED SETBACKS
FRO S R. SIDE
RE R L. SIDE V /
LAKE WETLANDS
ACCESS
EXISTING
AG NCY-APPROV. DATE
CITY
CO N Y
STATE
PRIVATE EASEMENT
REMARKS:
PERMIT NO. 5788
DATE ISSUED 4 -- S_
SITE ADDRESS�LP
PROPERTY IDENTIFICATION NO (PID11
LOT____r_S�_BLOCK 1 SUBDIVISION ICE 1142cl
[OINER It
(Name) (Address) - 3 (Phone) /
{ i'iLL`�C�•� I ���)r �]Gl L11 • Yftrv.nhu ft*�
CHITECT/ENGINEER - Must Certify Multi -Family. Commercial & Industrial C4111struction Plans
(Firm) IAddressl (Phone)
BUILDER (Firm)
r
(Address) (Phorlel
TYPE OF WORK eW Addition
Remodel
Renovate
CONST. TYPE
BUILDING SIZE
Estimated Construction Valuation
F
L. •� W. �� � Hr.
1 o
oo0
OCCUPANCY
PERMIT FEES
CLASSIFICATION
BLDG. PERMIT
, 100
DWELL.
STORIES B t 20 3
UNITS
STATE FEE
/,
' �y
GAR. %ALLS
NUMBER OF BEDROOMS
ATT.
WLAN REVIEW
r n�
DET.
SAC CHARGE
c
SEPTIC /
APP. DATE
SEWER UNIT
_
PROPOSED USE
PARK FEE
PENALTY
_._-
COUNCIL
APP. DATE
OTHER
IINCOECTION REQUIRED WORK REQUIRING
SEPARATE PERMITS
... FOOTING before pour
..... FRAMING rough -in PLUMBING L ...................
..... INSULATION MECHANICAL......................
..... WALLBOARD before taping
...... FINAL before occupancy WELL .............................
...... SITE INSPECTION SEPTIC .........................
WORK BEYOND OR WITHOUT A RE- SEWER ❑
OUIRED INSPECTION WILL BE SUB- WATER ❑
JECT TO PENALTY.
❑
INSPECTIONS MUST BE CALLED -IN GRADING & FILLING
24 HOURS IN ADVANCE. FIRE ❑
COPY WHITE -FILE GREEN -FINANCE
CANARY -INSPECTOR GOLD -RECEIPT
PINK -ASSESSOR
MOohN. ►nb &Ach Co Inc 1612)5614alo
TOTAL DUE % //&7 T,
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-
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
OF MINNESOTA BUILDI CODE REQUIREMENTS
ro
S.gnatu'e Date
of Orono