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CITY of ORONO <br /> Buildin Permit PERMIT NO. Jr93O � <br /> g <br /> AND APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ISSUED U � <br /> P.O. BOX 66, CRYSTAL BAY, MN 55323 473-7357 <br /> ZONING DISTRICT /��� � �,J �' <br /> SITE ADDRESS � �� �S� / N I G� �� • <br /> PROPERTY IDENTIFICATION NO.(PID) <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OWNER (Name) (Address) (Phone) <br /> c r� (it�a-�. � �:�n� -D D' <br /> VAR. DATE CHITECT/ENGINEER- Must Ce ify Multi-Family,Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> WIDTH D TH ���`�� <br /> TYPE OF WORK New Addition Remodel Renovate <br /> PROPOSED T CKS: U�� <br /> FRONT R. SI E � <br /> CONST.TYPE BUILDING SIZE timated Construction Valuation <br /> REAR L SIDE '� <br /> L. W. H t. � <br /> LAKE WETLANDS <br /> (� OCCUPANCY PERMIT FEES <br /> U CLASSIFICATION <br /> AC ESS DWELL. STORIES B 1 2 3 BLDG. PERMIT � ' �� <br /> UNITS � . � <br /> STATE FEE <br /> NE EXISTING GAR. STALLS NUMBER OF BEDROOMS <br /> AGENC -APPROV. DATE q� PLAN REVIEW <br /> CITY DET. SEPTIC <br /> APP. DATE SAC CHARGE <br /> COUNTY PROPOSED USE SEWER UNIT <br /> STATE PARK FEE <br /> PE N A LTY <br /> PRIVATE EASEMENT COUNCIL <br /> APP. DATE OTHER <br /> REMARKS: �(,_/� C _� �-. � � TOTAL DUE �� C� <br /> J <br /> � �l <br /> �� ��� <br /> �l r� s 1 e a r�G`�S _ ct rr'a/ �',�� <br /> WORK REQUIRING 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. AND DECLARES <br /> ❑ . . . . . . INSULATION MECHANICA�....................... ❑ UNDER PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPT- <br /> . . . . . <br /> WALLBOARD before taping ANCE OF ALL INFORMATION, CONDITIONS AND REQUIRE- <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. �^/ATER.............................. ❑ <br /> OF MIN SOTA UILDING CODE REQUIREMENTS. <br /> GRADING&FILLING ............... <br /> INSPECTIONS MUST BE CALLED-IN ` - <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ `',I�,,ry <br /> Signature Date ��� <br /> ;OPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approve � �1� of Orono <br /> �klyn Prtg.&Adv.Co.Ina (672)567-4470 I�� / <br />