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CITY of ORONO <br /> Building Permit PERMIT NO. 5H1� � <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED �D� a -1S � <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT <br /> SITE ADDRESS <br /> PROPERTY IDENTIFICATION NO.(PID) — <br /> FIRE DEPARTMENT LOT BLOCK + SUBDIVISION <br /> POST OFFICE OWNER (Name) (Address) (Phone) <br /> . /- �-y� <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family,Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. US DATE <br /> LOT A EA BUILDER (Firm) (Address) s� <br /> �oc��- �alo(P <br /> WIDT DEPTH � ���� <br /> PE OF WORK New Addition model e vate <br /> PRO E SETBAC <br /> FRO R. ID `e � <br /> CONST.TYPE BUILDING SIZE Estimated Construction Valuation <br /> REA . I <br /> L. W. Ht. ��� �! <br /> LAKE TLANDS <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION �'/. �� <br /> ACCES DWELL. STORIES B 1 2 3 BLDG. PERMIT a <br /> UNITS /� S'� <br /> STATE FEE <br /> NEW EXISTING GAR.STALLS NUMBER OF BEDROOMS <br /> AGENCY-APPROV. DATE q�_ PLAN REVIEW <br /> CITY DET. SEPTIC <br /> APP. DATE SAC CHARGE <br /> COUNTY PROPOSED USE SEWER UNIT <br /> STATE PARK FEE <br /> PENALTY �� � <br /> PRIVATE EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> TOTA L D U E Q�, �� <br /> REMARKS: U <br /> r <br /> WORK REQUIRING ACKNOWLEDGEMENT <br /> INSPECTION REQUIRED SEPARATE PERMITS <br /> ❑ .. . . . . FOOTING before pour THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> ❑ .... . . FRAMING rough-in PLUMBING ......................... ❑ THE REAL IMPROVEMENTS SPECIFIED. AND DECIARES <br /> ❑ ... . . . INSULATION MECHANICAL....................... ❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br /> ❑ . WALLBOARD before taping ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <br /> . .. . . <br /> WELL............................... <br /> . ... . . FINAL before occupancy <br /> ❑ .... . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE- SIGNED FURTHER AGREES TO DO ALl WORK IN STRICT COM- <br /> SEWER.............................. <br /> QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. ❑ <br /> GRADING&FILLING ............... ❑ <br /> OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> INSPECTIONS MUST BE CAILED-IN <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ i <br /> Signat e te <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approved C' of Orono <br /> Brooklyn Prtg.&Adv.Co.Inc. (672)561-4470 <br />