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CITY of ORONO <br /> Buildin Permit PERMIT NO. 614�r � <br /> g � �� <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 ��V �' �C�GLJ�� <br /> PROPERTY IDENTIFICATION NO.(PID) ��— ��'� �` ��— E�2`Y�� <br /> FIRE DEPARTMENT LOT BLOCK SUBDIVISION <br /> POST OFFICE OWNER (Name) (Addr�ss (Phone) <br /> \ � /7 /`f'.a-° ' � U /1.�. <br /> " �J/'1 <br /> VAR. DATE ARCHITECT/ GINEER- Must Certify Multi-Family,Commercial& Industrial Construction Plans <br /> (Firm) (Address) (Phone) <br /> COND. USE DATE <br /> LOT AREA BUILDER (Firm) (Address) (Phone) <br /> WIDTH D 1 G' {'��)LC� � � .��5/� �-L��7 i�,?G%t[1/� <br /> YPE F WORK New A ition Remodel enov <br /> PROPOSED SE C S: �� � <br /> FRO R. / Ch--,� <br /> CONST.TYPE BUILDING SIZE stimated Construction Valuation <br /> REAR <br /> L. W. Ht. / <br /> LAKE TLA S ' <br /> OCCUPANCY PERMIT FEES <br /> - CLASSIFICATION � � <br /> ACCE S DWELL. STORIES B 1 p 3 BLDG. PERMIT •..� <br /> UNITS STATE FEE �v <br /> NEW EXI TING GAR.STALLS NUMBER OF BEDROOMS <br /> AGENCY-APP DATE ATT. PLAN REVIEW <br /> CITY�"- DET. SEPTIC <br /> �� APP. DATE SAC CHARGE <br /> CO TY PROPOSED USE SEWER UNIT <br /> ST PARK FEE <br /> PENALTY <br /> PRIVATE SEMENT COUNCIL <br /> APP. DATE OTHER <br /> � I ' _ TOTALDUE � � <br /> REMARKS: � l`✓ l ,L,G. .� r �t' -�-�- •� (� <br /> 1`�� b,P�,✓✓� �.� c�ll ��t � /�=e���� <br /> � <br /> INSPECTION REQUIRED WORK REQUIRING ACKNOWLEDGEMENT <br /> SEPARATE PERMITS THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE <br /> ❑ . . . . . . FOOTING before pour <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 /> WELL............................... ❑ <br /> . . . . . . <br /> FINAL before occupancy <br /> ❑ . . . . . SITE INSPECTION SEPTIC.............................. � MENTS REPRESENTED ON THIS DOCUMENT. THE UNDER- <br /> WORK BEYOND OR WITHOUT A RE- SIGNED FURTHER AGREES TO DO ALL WORK IN STRICT COM- <br /> SEWER.............................. <br /> QUIRED INSPECTION WILL BE SUB- PLIANCE WITH ALL CITY OF OR O ORDINANCES AND STATE <br /> JECT TO PENALTY. WATER.............................. ❑ <br /> MIN SOTA BUILDIN E QUIREMENTS. <br /> GRADING& FILLING ............... ❑ <br /> INSPECTIONS MUST BE CALLED-IN i � <br /> 24 HOURS IN ADVANCE. FIRE................................. ❑ , ,c,\, —� <br /> Signa -'�' Date'�"� <br /> COPY:WHITE-FILE GREEN-FINANCE <br /> CANARY-INSPECTOR GOLD-RECEIPT <br /> PINK-ASSESSOR Approve City of Orono <br /> Brooklyn Prtg.&Adv.Co.Ina (612)561-0470 <br />