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Owner <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />/ i'7 rA Consi~' <br />CITY PERMIT N9 8852 <br />D».c_____ <br />__ 33 “^^ ft h, <br />_____ ^u.'rAuUiU^ Adte P.oQk.-^'-(J^ ■---------- <br />^<39b'__________^City License No. <br />REMARKS AND SPECIAL COWITIONS <br />City _ <br />:owmoNS <br />Hr mi^ <br />PERMIT TYPE AND FEE ^NEW □ ADDITION □ REPAIR □ REMODEL <br />Inside Plumbing (^fixtures )Fee S .Water Well Fee S <br />Fee S Mechanical Equipment Fee S <br />Fircpiace/Wood Stove Fee $ <br />Moving/Lifting Buildings Fee S <br />Municipal Wiier Connection Fee S .Land Alteration (Excavation,Fee SGrading. Filling, etc.)□ Copper □Design Review Fee $ <br />Municipal Sewer Connection Fee S .Fee S <br />□ PVC □ Qst □Sprinkler System (Fire)Fee S <br />MWee SAC Charge Fee S .Fee 5: <br />On Site Spetic S^tem Fee S .After-the-fact Investigation Fee S <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges axeiiH of ihis limiled pciniil, <br />including acccpuina* i>f all sivcial inromulion, terms. ctinJiliorvs iv <br />Tcquircmenis WTitten aKwe. Tlit undersigned understands and agrees <br />under penalty i>f law that this permit is strictly limited in saijv to the work, <br />activity or improvement specified; that this permit d<vs nvM grant any <br />authority todo work oratlivilics riHiuiringsrparaie permit approvals; and <br />that litis pemtitdocsnotgrantaulhoriiv to viobteany provision ofany City <br />ordinance or State bw, rule or rvgubtion. All work shall be done in strict <br />cvtmpliana* with all City ordinances, building codes and/or health <br />department regubtionv and shall be subject to inspection, approval or <br />rcjiYtion by the City. Whenever so ordered, the undersigned agrees to <br />cttmxT any work found to be in virtlition t>f the ittndilitms t»l this permit. <br />Signature <br />U 'A LijU^ <br />TOTAL <br />Slate Surcharge: <br />Total Amount Riid to City <br />Fee $ <br />Fee $'7s^v <br />This permit is not \’alid until the proper fee is paid and it is approved <br />by an authorized City Oflicial. <br />Signal^ of City Oflirial <br />Code: White—File Copy Canary —Inspector's Copy Pink—Finana* Copy Gold—Appltcanfs Receipt