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CITYofORONO <br />Building Permit <br />AND APPLICATION FOR CERTIHOATE OF OCCUPANCY <br />P.O. BOX 66. CRYSTAL BAY. MN 55323 473-7357 <br />PERMIT NO. 5912' <br />DATE ISSUED V" <br />S>U< -S.SITE ADDRESS <br />PROPERTY IDENTIFICATION NO (PID) Qjtj ' // 7 ' I <br />LOT______________BLOCK___________________ SUBDIVISION <br />OWN^ (Name) (Address) ^ (Phone) <br />^ /zk'HciJUS &i<Di4)n £e!^^ <br />ARCHITECT/ENG^Ni: tn Must Certify Multi-Family. Corr 'rcial & Industrial Construction Plans <br />(Firm) (Address) (Phone) <br />BUILDER (Firm)I • ndrer >)(Phone) <br />TYPE OF WORK New Addition Remodel Renovate <br />CONST^Pt BUILDING SIZE <br />L W Ht ka <br />OCCUPANCY <br />CLASSIFICATION <br />DWELL <br />UNITS <br />GAR STALLS <br />ATT <br />DET <br />STORIES B <br />NUMBER OF BEDROOMS <br />SEPTIC <br />APP DATE <br />PROPOSED USE <br />COUNCIL <br />APP DATE <br />REMARKS <br />Estimated Construction Valuation <br />PERMIT FEES <br />BLDG PERMIT _____ <br />STATE FEE _____ <br />PLAN REVIEW _____ <br />SAC CHARGE ______ <br />SEWER UNIT______ <br />PARK FEE _____ <br />PENALTY _____ <br />TOTAL DUE <br />I <br />INSPECTION REQUIRED WORK REQUIRING <br />SEPARATE PERMITS <br />U.............FOOTING before pour <br />□.............FRAMING rough in PLUMBING .................□ <br />□.............INSULATION MECHANICAL □ <br />G.............WALLBOARD before taping <br />WELL ..........................□Q.............final before occupancy <br />□.............SITE INSPECTION SEPTIC ..................................□ <br />WORK BEYOND OR WITHOUT A RE­SEWER ...................□ <br />QUIRED INSPECTION WILL BE SUB WATER ..........□JECT TO PENALTY <br />INSPECTIONS MUST BE CALLED-IN <br />GRADING A FILLING ..........□ <br />24 HOURS IN ADVANCE FIRE Q <br />COPY WHlTf pile <br />CANARy INSPECTOR <br />PINK ASSESSOR <br />■rooirtv* a Go K«c Wif»Ml4tTQ <br />CiRLEN FINANCE <br />Goto RECEIPT <br />ACKNOWLEDGEMENT <br />THE UNDTRiIGNFD HLF?tBY RFQUESTS PERMISSION TO MAKE <br />THE RLAL improvements SPECIFIED AND DECLARES <br />UNDER PENAlTV OE LAW ACKNOWLEDGEMENT AND ACCEPT­ <br />ANCE OF ALL INFORMATION CONDITIONS AND REQUIRE <br />MFNTS REPRESENTED ON THIS DOCUMENT THE UNDER <br />SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM <br />PLIANCf WITH All CITY OF ORONO ORDINANCES AND STATE <br />OF MINNESOTA BUILDING CODE REQUIREMENTS <br />Apufoved <br />Ty^’llacs .Date rip <br />IAI Tjf .C«ty of Orono