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CITYof ORONO <br />Building: Permit <br />AND APPLICATION FOR CERTIFICATE OF OCCUPA^’ :Y <br />P.O. BOX 66. CRYSTAL BAY, MN 55323 473-7357 <br />SITE ADDRESS pElafag. <br />PERMIT N9 . 4118 <br />DATE ISSUED _/# " <br />EXPIRES________________ <br />ZONING DISTRICT <br />FIRE ZONE <br />VAR. DATE <br />2.S -7-? <br />COND. USE DATE <br />LOT AREA <br />WIDTH DEPTH <br />PROPOSED SETBACKS <br />FRONT R.SIDE <br />REAR L.SIDE <br />LAKE WETLANDS <br />ACCESS <br />NEW EXISTING <br />AGENCY-APPROV. DATE <br />CITY <br />COUNTY <br />STATE <br />PR. EASEMENT <br />LEGAL DESCRIPTION: PROP. ID.. <br />ARCHITECT/ENGINEER - Must Certify Multi-Family, Commercial & Industrial Construction Plans <br />CERT.NO _______ <br />(Firm) (Address) (Phone) <br />BUILDER (Firm) (Address) (Phone) <br />TYPE OF WORK New ^’^dition,^ Remodel Renovate <br />Qsr , <br />CONST. TYPE BLDG. SIZE ■* <br />L. /1_ W. 2-H- Ht. <br />E^ILCONST. VALUATION <br />RESIDENTIAL STORIES B 1 2 3 <br />BDRMS/FLR <br />PERMIT FEES c>c» <br />BLDG. PERMIT JtV* <br />DWELL. <br />UNITS <br />~ f --STATE FEE / <br />GAR. STALLS <br />ATT. <br />DET. <br />SEPTIC <br />APP. DATE PLAN REVIEW ___i. - i <br />DOCK <br />PENALTY <br />PARK FEENONRESIDPROPOSED USE <br />SAC CHARGE *OCC. <br />CLASS <br />STORIES COUNCIL <br />APP. DATE TOTAL DUE STo <br />REMARKS: <br />INSPE^^^ REQUIRED <br />FOOTING belora pour <br />FRAMING rough-in <br />INSIJI ATiniM <br />WORK REQUIRING <br />SEPARATE PERMITS <br />PLUMBING <br />JDMTC lBOARO Before Taping MECHANICAL <br />% ■ •__^ _ _________ —well <br />SEPTIC __ <br />WORK BEYOND OR WITHOUT A RE <br />QUIRED INSPECTION WILL BE SUB­ <br />JECT TO PENALTY. <br />INSPECTION HOURS 473-73S7 <br />CALLS - 12 A.M. INSP. 1 - 4 P.M. <br />SEWER <br />WATER _ <br />GRADING a FILLING <br />CALL 1 • 4 P.M. INSP. NEXT DAY ELECTRICAL Irom Suit <br />COPY: WHITE-FILE <br />CANARY- INSPECTOR <br />PINK-ASSESSOR <br />GREEN-FINANCE <br />GOLD-RECEIPT <br />ACKNOWLEDGEMENT <br />THE UNDERSIGNED HEREBN REQUESTS PERMISSION TO MAKE <br />THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES <br />UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT­ <br />ANCE OF ALL INFORMATION. CONDITIONS AND REQUIRE- <br />MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER­ <br />SIGNED FURTHER AGREES TO DO ALL WORKS IN STRICT COM­ <br />PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br />OF MINNESOTA BUILDING CODE REQUIREMENTS. <br />Signatu^ <br />Approved City of Orono