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CITY of ()R()1T() <br /> Building Permit PERMIT NO. 6`�67 � <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED _ /�/���� <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT �� � � <br /> SITE ADDRESS - <br /> PROPERTY IDENTIFICATION NO.(PID) ��.�� ' <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE O NER (Nar�e) (Address) (Phone) <br /> /, . <br /> ,ll,�l�L' � ��..� '�.. <br /> VAR. DATE ARCHITECT/ENGINEER- Must Certify Multi-Family, Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT AREA ILDER � (Firm) (Address) (Phone) <br /> f � / ) � <br /> WIDTI-� „` DEPT' .I ( C � � �� 1 C ���� /" -- � ;'l , i II�� I • �/ y/ � - C :7 <br /> l: <br /> ' � TYPE OF WORK New Ad tion Remodel Renovate <br /> PR PO ED SETBA r �{�- <br /> FR T R.SMD � �1�, r 1 �-L_- 1 <br /> � CONST.TYPE BUILDING SIZE <br /> REA n L DE Estimated Construction Valuation <br /> / / <br /> LL,'t�k� L. - � W. / /C� / Ht.�� ' �7 �,�,�; Fj�^ <br /> LAKE ETLANDS <br /> CCUPANCY PERMIT FEES <br /> CLASSIFICATION f— �•—^ <br /> DWELL. BLDG. PERMIT � � � � � <br /> ACCESS STORIES B 1 2 3 -�. <br /> UNITS STATE FEE `�' �.� <br /> NEW EXISTING GAR. STALLS NUMBER OF BEDROOMS <br /> AGENCY-APPROV. DATE ATT. 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 /> REMARKS: TOTAL DUE `"> \ <br /> ��' � �a <br /> WORK REQUIRING ACKNOWLEDGEMENT <br /> PECTION REQUIRED SEPARATE PERMITS <br /> . . . . . FOOTING before pour THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO �4AKE <br /> ' . . . . . . FRAMING rough-in PLUMBING ......................... ❑ THE REAL IMPROVEMENTS SPECIFIED. AND 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- SEWER.............................. � SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br /> QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE <br /> JECT TO PENALTY. V�/ATER............. ❑ <br /> OF MINNESOTA BUILDING CODE REQUIREMENTS. <br /> GRADING&FILLING ............... ❑ <br /> INSPECTIONS MUST BE CALLED-IN <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ ���e'�"'"'"f' ��x.rvt r�'C��S� <br /> Signature Date <br /> COPY:WHITE-FILE GREEN-FINANCE � <br /> CANARY-INSPECTOR GOLD-RECEIPT ` <br /> PINK-ASSESSOR Approved ' � �ity of Orono <br /> Brooklyn Prtg.&Ativ.Co.Inc. (612)561-0470 <br />