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<br /> � Permit �, ;
<br /> DATE ISSUED_�_�=�� i ,q
<br /> �� AND APPUCATION FOR CERTIFICATE OF OC�UPANCY EXPIRES '�
<br /> P.O. BOX 6S, C�L BAY, MN 55323 473 7357 �, , -- — '
<br /> 2'JNING qiaTRiCT SITE ADDRESS _���`�_ ._�tf t'•���r :, . ._��-� '
<br /> LEGAL DESCRIPTION: PROP. ID. '`r �C /� - '7��c? �
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<br /> LOT__ ,,� BLOCK_ ' SUBDIVISION^____ "�
<br /> FIRE ZONE
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<br /> WNER (Name) ' / Address) (PFhone)
<br /> VAR. L`ATE � ` /Cltt �(/Pil-� il<< c.-<=---
<br /> ARCHITECT/ENGINEER-Must Certify Multi Family,Commercial & Industrial Constructiun Flans
<br /> COND. USE DATE ERT.NO.
<br /> - - - ----- '
<br /> _ (Firml (Adciress) (Phone)
<br /> LOT AREA
<br /> WIDTH DEPTH BUILDER (Firm) ddress) (Phone) `>'
<br /> PRQPOSED SETBACKS 6""«�� ���'�'t"�� -
<br /> '' FRONT R.SIDE TYPE OF WORK New Addition Hemodcl Renovat-e' �
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<br /> REAR L.SIDE `i-
<br /> CONST. TYPE BLDG.SIZE EST.CONST.VAL�ATION `�,.
<br /> LAKE WET�ANDS
<br /> L. w. F�� ���.�-y _
<br /> ACCESS RESIDENTIA sTORiEs e i 2 s PERMIT FEE.S `
<br /> NEW EXiSTING BLDG. PERMIT /C� �' �
<br /> DWELL BDRMS/FLR �� f
<br /> AGENCY-APPRC�V. DATE urvirs STATE FEE �
<br /> CITY GAR STALLS SEPTiC `f '•�
<br /> ATT APP. DATE PLAN REVIEW ;� �
<br /> COUNTY DE7. PENALTY �r �vN
<br /> DOCK d
<br /> STATE NON RESID PROPOSED USE PARK FEE __ 1
<br /> {. PR. EASEMENT OCC SAC CHARGE
<br /> CLASS.
<br /> STORIES COUNCIL v 4 z'
<br /> APP.DnTE TOTAL DUE ��>'��
<br /> REMARKS: � - � � ,�r� "/ #
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<br /> iNSPECTiON REQUIRED WORK REQUIRING ACKNOWLEDGEMENT
<br /> __ FOOTINGbetorepour SEPARATE PERMITS
<br /> _FRAh11NG rough�in
<br /> THE UNDEfiSIGNED f1EREBY REQUESTS PEFMISSION TO MAKE
<br /> " _INSULATION PWMBING _________________ 7HE REAL IMPROVEMENTS SPEGFIED, AND DECLARES
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<br /> ; WALLBOARD Before Taping MECHANICAL__________ _._ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT
<br /> ` __FINAL befoce occupancy WELL ___,__._.___ ______. ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE �` S
<br /> SEPTIC______ ---___ MENTS REPRESENTED ON TF:IS DOCUt�1ENT THE UNDER-
<br /> WORK BEYOND OR WITHGUT A RE- SEWER _________ ___.__
<br /> 4UIRE0 INSPECTION WILL BE SU& WATER SIGNED FURTHER AGREES TO DO AtL WORKS IN STRICT COM
<br /> � JECT TO PENALTY, --
<br /> � GRADING&FILLING _ PUANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE
<br /> Ii�SPECTION HOURS 473-7357
<br /> CALLB 12 A.M. ,NSP. 1 -0 P.M. OF MINNESOT4 E3U�LDWG CODE REQUIREMENT;.
<br /> CALI 1 - 4 P.M. INSP.NEXT DAY ELECTRICAL from State t '
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<br /> � Signature .-�•��. � ,i.S���3Y�y._ Date��'� .1_.1_.'.��_
<br /> k� COPY: WHITE-FILE GREEN -FINANCE
<br /> i$ CANARY--1NSPECTOf7 GOLD RECEIP7 i-� '' �'
<br /> �. PINK—ASSESSOF �� --�e"'"----------- .' s
<br /> ApprUved �" Ciry o/O�ono '���
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