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APPLICATION FOR BUILDING PERMIT <br />AND CERTIFICATE OF OCCUPANCY <br />VILLAGE OF ORONO, MINNESOTA <br />DIRECTIONS: PERMIT NUMBER <br />SPACES NUMBERED 1 THRU 13 MUST BE FI�LEO IN <br />BEFORE PERMIT IS ISSUED (Please Print or Type) I <br />1. SITZ ADDRESS J6 <br />2. DATE <br />3. LEGAL DESCRIPTION <br />6T l�- I3� <br />h-1 1 1,yH r %a !v k A <br />PLAT NUMBER <br />4. OWNER/(home) <br />v <br />5. ARCHITECT (Name) <br />6. BUILDER (Name) <br />7. TYPE OF WORK <br />b 1?0N6 \/'/LGA0P. <br />PARCEL NUMBER <br />�� �(A�ddress) (Tel. No.) <br />: �'Ll.J <br />(Tel. No.) <br />(Tel. No.) <br />NEW CONSTRUCTION O ALTERATIONS O ADDITION O FINISH ATTIC ❑ <br />FINISH BASEMENT O PORCH ❑ GARAGE O REROOF ❑ RESIDE ❑ MISC. <br />B. SIZE OF STRUCTURE <br />(Helpht) (Width) (Depth) <br />11. COMPLETION DATE <br />14. TYPE OF CONSTRUCTION <br />17. FRONT YARD <br />FT. <br />9. NO. OF STORIES <br />12. PROPERTY DIMENSIONS <br />WIDTH �� DEPTH <br />15. PROPER A� <br />SQ. FT. `/_ C In <br />18. REAR YARD <br />FT. <br />10. ESTIMATED COST <br />17. NO. OF FAMILIES (If Applicable) <br />16. LOT AREA PER FAMILY <br />SQ. FT. _ <br />19. SIDE YARDS <br />(1) FT (2) FT. ET. 0 x 2) FT. <br />20. FLOOR AREA APPORTIONMENT <br />USE. AREA <br />SQ. FT. <br />e/' <br />SQ. FT. <br />SQ. FT. <br />AGGREGATE FLOOR AREA SQ. FT. <br />ACKNOWLEDGMENT'; AND SIGNATURE: <br />The undersigned hereby represents upon all of the penalties of lain, for the <br />purpose of inducing the Village of Orono to take.thc action hcrcin requested, that <br />all Statements licrcin are true and that all work hcrcin mentioned will be done in <br />accordance with the ordinance of the Village of Orono, the State of illinnesota, <br />and rulings of the Building Department. <br />�k 13 _a�o_ Sr o 4 ,S �- N <br />&NATURE APPROVED <br />PERMIT FEE <br />PLAN CHECK FEE <br />PENALTY FEE <br />TOTAL FEE <br />ZONING DISTRICT <br />FIRE ZONE <br />AGGREGATE' FLOOR AREA <br />FLOOR AREA RATIO <br />OFFSTREET PARKING <br />SPACES REQ. <br />SPACES ON PLAN <br />LOADING BERTHS <br />NUMBER REQ. <br />NUMBER PROVIDED <br />SIZE OF EACH <br />NUMBER OF OCCUPANTS OR SEATS <br />OCCUPANTS <br />SEATS <br />MATERIAL FILED WITH APPLICATION <br />SOIL TESTS O <br />PILING LOCI ❑ <br />PLANS & SPECS. O SETS <br />SURVEY O COPIES <br />PROPOSED GRADE FOUNDATION <br />IN RELATION TO CURB OR CROWN <br />OF STREETt <br />CERTIFICATE OF OCCUPANCY ISSUED <br />DATE BY <br />