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APPLICATION FOR BUILDING PERMIT <br />AND CERTIFICATE OF OCCUPANCY <br />VILLAGE OF ORONO, MINNESOTA <br />DIRECTIONS: <br />SPACES NUMBERED 1 THRU 13 MUST BE FILLED IN <br />BEFORE PERMIT IS 1cmirn IPI—. P.— — T.. 1 <br />PERMIT NO <br />NO ?911 <br />1 <br />SITE ADDRESS <br />v <br />2. DATE 3 <br />17 <br />3. <br />LEGAL SCRIPTION <br />PLAT NUMBER PARCEL NUMBER L lJ <br />1, <br />OWNER <br />( el to IAddressl <br />(Tel. No.) <br />5. <br />ARCHITECT <br />INsme) (Address) <br />(Tel. No.) <br />6 <br />BUILDER <br />( 1 (Address) <br />7a 7oQ <br />(Tel. No.) <br />7 <br />TYPE OF WORK <br />8 <br />SIZE OF STRUCTURE <br />IH.:ydi (W,dth) <br />(Depth) <br />9. NO OF STORIES <br />/ <br />10. ESTIMATED COST <br />11. <br />COMPLETION DATE <br />12. PROPERTY DIMENSIONS <br />13. NO OF FAMILIES (H Applicable) <br />1 17 FRONT YARD <br />Ip rHUrtHIT AHtA <br />16. REAR YARD <br />w L- AHtA 1'tH FAMILY <br />SIDE YARDS <br />ACKNOWLEDGEMENT AND SIGNATURE: <br />The undersigned hereby represents upon all of the penalties of <br />law, for the purpose of inducing the VILLAGE OF ORONO to take <br />the action herein requested, that all sta'iements herein are true <br />and that all work herein mentioned will be done in accordance with <br />the ordinance of the VILLAGE OF ORONO, the State of Minnesota, <br />and rulings of the Building Department. <br />1 <br />SIGNATURE / APPR D <br />PERMIT FEE /C) /' - <br />7hT'FEE J• D <br />i <br />ALTY FEE �� U 0 <br />TOTAL FEE <br />ZONING DISTRICT <br />FIRE ZONE <br />AGGREGATE FL(IOR�I1?5 <br />FLOOR AREA RA//TII--Off-- �� <br />MATERIAL FILE WITH <br />OFFSTREET PARKING <br />CONSTRUCTION <br />1� <br />FOOTING —A "-L <br />FRAMING — <br />FINAL <br />CERTIFICATE OF OCCUPANCY ISSUED <br />DATE BY <br />