HomeMy WebLinkAbout1983-11-25 Permit, New Residence #5177CITYofOROXO
Building Permit
T' .
PERMIT N? 1' 51771
AND APPLICATION FOR CERTIFICATE OF OCCUPANCY
P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357
SITE ADDRESSZONING DISTRICT
FIRE ZONE
LaK-C
varToate
COND. USE DATE
LOT AREA
WIDTH DEPTH
PROPOSED SETBACKS
FRONT R.SIDE.
/06 ■» -IQf} -f-
REAR,5'6'L.SIDE ,
LAKE WETLANDS
ic'
ACCESS
EXISTING
AGENCY APPROV. DATE
CITY
COUNTY
STATE
PR. EASEMENT
Fre.«v4j\ Lac£Xci
■/Ji)/ f-.
0 rfeAt,V\ Lail-F
DATE ISSUED
EXPIRES __
LEGAL DESCRIPTION: PROP. ID. iO '1(7 ^^3
LOT BLOCK ^.SUBDIVISION,
OWNER (Namel (Address) (Phone)
ARCHITECT/ENGINEER
CERT.NO.
(Fiijri)
ust Certify Uulti Family, Commercial & Industrial (instruction PlansMust Certify
1>r
(Address)
|\nstru
[w
(Phor^
l
BUILDER (Firm)
^ >5
3S'.rs''''iS(fere£
<U ivi
(Phone)
^20 -499k.
TYPE OF WORK
CONy TYPE
I
Addition Remodel Renovate
v\ / ^
BLOC, Sl/E
L VV Ht
hesiuentjal
P 3
DWt LL
UNI TS I
STORIES B 1 ?
ODRMS FLR
H
(,AH STALLS
^ 3
OET
SEPTIC J 3
APP DATE ff " LS ^
NON RESIO
OCC
CLASS
DOCK
PROPOSED USE
EST CONST valuation
^l^cca
PERMIT FEES
BLDG PERMIT IIZ S , ^
STATE FEE
PLAN REVIEW
PENALTY
PARK FEE
SAC CHARGE
Ig^A 6«
419.f>c>
hi^)
STORIES COUNCIL
APP DATE TOTAL DUE
REMARKS:
INSPECTION REQUIRED
, FOOTING before pouf
__FRAMING rou^h m
_ INSULATIC N
_____WALLBOARO Before Tapinq
_____-FINAL before occupancy
WORK BEYOND OR WITHOUT A RE
QUIRED INSPECTION WILL BE SUB
JECT TO penalty
INSPECTION HOURS 473 /357
CALLS 13 A M INSP I 4PM
CALL 1 4 P M INSP NEXT DAY
WORK REQUIRING
SEPARATE PERMITS
PLUMBING________
MECHANICAL_____
WELL . .
SEPTIC _ _ _ _ _ _ _ _
SEWER_ _ _ _ _ _ _ _ _
WATER .. . . . . . .. .
GRADING & filling______
ELECTRICAL from State
ACKNOWLEDGEMENT
the UNDERSIGNED HEREBY REQUESTS PERMISSfON TO MAKE
THE REAL fMPROVEMENTS 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 WORKS IN STRICT COM
PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND ST ATE
OF MINNESOTA BUILDING CODE REQUIREMENTS
Signatur^^Date
COPY WHITE file
CANARY INSPECTOR
PINK-ASSESSOR
GREEN FINANCE
COLD RECEIPT
Approved fiaj Ctry of Orono J