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CITY of ORONO <br /> Building Permit PER^"�T "o. � 563i <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED S�'� <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT �7-��"� <br /> SITE ADDRESS <br /> PROPERTY IDENTIFICATION NO.(PID) � �'� <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OW ER (Name) (Address) (Phone) <br /> , -�/� � �7 � � �/'9!� <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family,Commercial& Ind al Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> WIDTH EPTH <br /> TYPE OF WORK New Addition odel Renovate <br /> PROPO D ACKS: �y <br /> FRONT R.SIDE '� (�_ <br /> CONST.TYPE BUILDING SIZE Estimate onstruction Valuation <br /> REAR L. SIDE <br /> . <br /> L. W. Ht. � ' <br /> LAKE T A S <br /> OCCUPANCY PERMIT FEES <br /> CLASSIFICATION , � � <br /> ACCESS DWELL. STORIES B 1 p 3 BLDG. PERMIT <br /> UNITS STATE FEE � <br /> NEW XISTING GAR.STALLS NUMBER OF BEDROOMS <br /> AGENCY-APPROV. DATE qn. 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 /> TOTAL DUE � <br /> REMARKS: � <br /> WORK RECIUIRING 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. ANO DECLARES <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 /> QUIREp INSPECTION WILL BE SUB- P�IANCE wITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> WATER.............................. <br /> JECT TO PENALTY. OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> GRADING 8 FILLING ............... ❑ <br /> INSPECTIONS MUST BE CALLED-IN � <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ „ , �r <br /> Signatu Date <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approved L'� 'y of Orono <br /> Brooklyn Prtg.&Adv.Co.Inc. (612)561�470 <br />