HomeMy WebLinkAbout1986-11-25 App. & Permit, New Residence #6237r
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CITYoTOROXO
Building Permit
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66. CRYSTAL BAY, MN 66323 473-7367
i)r.
PERMIT NO. 6237 '
DATE ISSUED 4
ZONIN
FIRE DEPARTMENTVRTMENT . I.ILfnxq laLf
POST OFFICEu3
VAR. DATE
JLj ^
COND. USE DATE
LOT AREA
WIDTH
PROPOSED SETBACKS: .
FRONTSIDE '
REA\o ^SIDE
LAKE WETLANDS 9 4-
ACCESS
6^,_ EXISTING
;yapprov. date
CITY
COUN
pi?. Qocci
Sty
STATE
PRIVATE EASEMENT
5ITE ADDRESS.y
WPERTY IDENTIFICATION NO (PIDl
LOT_____________BLOCK_________
//9 - n 7-^.? nrjt) y i
SUBDIVISION.
/
OWNER (Name) T (Address) (Phone)
2M\n Lrt A A a ^4-^ nt:ACo nr\^ht,lft,liJri,^cJif\a
A ICHITECT/ENGINEER - MustCertify Multi-Family. Commercial & Industrial Construct^h Rans
y (Firm)
Must Certify Multi-Family. Commercial & Industrial Construction
(Address) (Phone)
________ CONST TYPE
IILDER (Firm)(Address)(Phone)
^ "type^^rk
) Addition Remodel Renovate
BUILDING SIZE
L 71 'n (o ~Z Ht
Estimated Construction Valuation
OCCUPANCY
CLASSIFICATION
DWELL.
UNITS I STORIES B t 3
^^^TALLS
dIy
NUMBER OF BEDROOMS 3
APP DATE
PROPOSED USE
COUNCIL
APP. DATE
BLDG. PERMIT
STATE FEE
PLAN REVIEW
SAC CHARGE
SEWER UNIT
PARK FEE
PENALTY
OTHER
PfeRMIT FEES
! 0 Q.at)
<^^s:crz)
REMARKS:
total DUE
U
INSPECTION REQUIRED
FOOTING before pour
TRAMINQ rough-in
INSULATION
WALLBOARO before taping
FINAL before occupancy
[I^...........SITE INSPECTION
WORK BEYOND OR WITHOUT A RE
QUIRED INSPECTION WILL BE SUB
JECT TO PENALTY.
INSPECTIONS MUST BE CALLED IN
24 HOURS IN ADVANCE.
WORK REQUIRING
SEPARATE PERMITS
PLUMBING..........................
MECHANICAL.......................
WELL....................................
SEPTIC..................................
SEWER.................................................D
WATER . ..........................................C
GRADING & FILLING...................... D
FIRE .................................□
tI
COPY: WHITE-FILE
CANARY-INSPECTOR
PINK-ASSESSOR
■raak»vnPn«.a Attv.Co Inc l6l»UI4«n>
ACKNOWLEDGEMENT
i'
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 Miri)<FS0T^ BUILDING ^ODE REQUIREMENTS
green-finance
GOLD RECEIPT
Siulat
1
Date
'ot Orono