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CITY of ORONO <br /> Building Permit PERMIT NO. 56gi, I <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED � S S <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT SITE ADDRESS �75 ��C-�� �a�r,l <br /> L PROPERTY IDENTIFICATION NO.(PID) <br /> FIR� DE�ARTMENT� LOT a- BLOCK I SUBDIVISION S'�%G�DLUS G�I�f��f�h <br /> �-.l! '�-� <br /> POST OFF E OWNER (Name) �p j�;G� (Add���a o q��ve N non�j 5 � <br /> �' ►� � 1 ✓� P � s <br /> VAR. DATE-� ARCHITECT/ENGINEER- Must Certify Multi-Family,Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE � <br /> ,_ orr� 5 8 � �� � 9a - �� <br /> LOT A A BUILDER (Firm) (Address) (Phone) <br /> �.D f� 13 Ic� 6 / � �xCe 5�'arJgl✓�f q351 G/p <br /> �TH DEPTH <br /> / '�"' TYPE OF W K New Addition Remodel Renovate <br /> PROPOSED SETBACKS: <br /> FRONT / R.SIDE O / ' eS • <br /> CONST.TYPE BUILDING SIZE Estimated Construction Valuation <br /> REAR L. SIDE � <br /> ._ ° �a5 o m- o0 <br /> LAKE WETLANDS <br /> �. r�e w. Hc. <br /> OCCUPANCY PERMIT FEES <br /> � '�j � CLASSIFICATION <br /> ACCESS DWE�L. STORIES g O 2 3 BLDG. PERMIT �y�� � <br /> � UNITS I STATE FEE ��a ' SO <br /> EXISTING STALLS NUMBER OF BE ROOMS �7� �S <br /> AGENCY-APPROV. DATE 2 PLAN REVIEW ' <br /> CITY DET. �, APPTDATE 7 8 � � SAC CHARGE �v1 S�� <br /> COUNTY PROPOSED USE SEWER UNIT <br /> STATE PARK FEE SU � <br /> PENALTY <br /> PRIVATE EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> REMARKS: TOTAL DUE / /_ C,�� �� <br /> 1�✓./ <br /> INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT <br /> SEPARATE PERMITS THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> � .. .. . . FOOTING before pour <br /> '�.. . . .. FRAMING rough-in PLUMBING ......................... � THE REAL IMPROVEMENTS SPECIFIED. AND DECLARES <br /> '�.. . . .. INSULATION MECHANICAL....................... � UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br /> . . ... . <br /> WALLBOARD before taping ANCE OF ALL INFORMATION. CONDITIONS AND REQUIRE- <br /> WELL.......... <br /> . . ... . FINAL before occupa�cy <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 OROINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. <br /> OF MINNESOTA BUILDING CODE REQUIREM S. <br /> GRADING 8 FILLING ............... ❑ <br /> INSPECTIONS MUST BE CALLED-IN i <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ '• eo,,,,�,� � <br /> Signatu �"�""►^ Date <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT < C�P� <br /> PINK-ASSESSOR Approved � City of Orono <br /> Brooklyn Vrtg.&Adv.Co.I�c. (61Z)561�470 <br />