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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 />L-Ck^nc^m Ctudt • <br />CITY PERMIT N9 8788 <br />Date <br />Contractor. <br />City License No.-fk^ ! (p ^f <br />Address <br />Address <br />City _ <br />I22/)I JM-1-kcLp.lJ^ ^ <br />REMARKS AND SPECIAL CONDmONS <br />PERMIT TYPE AND FEE* ^ NEW <br />Inside Plumbing (#fixturet^&) Fee $ <br />Water Meter (Size___) Fee $ <br />Meter ^_____________________ <br />□ ADDITION □ REPAIR <br />Remote # <br />Munidpai Witer Cbnnection <br />□ Copper □ ____ <br />Munidpai Sewer Cbnnecdon <br />□ PVC □ Cast □ <br />MWee SAC Charge <br />On Site Spetic System <br />Fee S <br />Fee $ <br />Fee $ <br />Fee S <br />\Vbter Well <br />Mechanical Equipment <br />Fiicplacc/Wood Stove <br />Moving/LirUng Buildings <br />Land Alteration (Excavation, <br />Grading. Filling, etc.) <br />Design Review <br />Fire_______________ <br />□ REMODEL <br />Fee $ _ <br />Fee $ _ <br />Fee $ _ <br />Fee $ _ <br />Sprinkler System (Rr^ <br />Other •J. <br />After-the-fact Investigation <br />Fee S_ _ _ _ _ <br />Fee $_ _ _ _ _ <br />Fee $_ _ _ _ _ <br />Fee $_ _ _ _ _ <br />Fee $ I • <br />Fee $_ _ _ _ _ <br />ACKNOWLEDGEMENT <br />The undcfMgncil hereby acknowledges rca-ijH ibis limited permiu <br />tncludtf^ aarpiance of all special informalion. icrms, a>ndiiions or <br />rcquircmenls uritien above. The undeisipned understands and agrees <br />under penalty of bvv that this pamil issirictly limited In fcope to the work* <br />activity or improvement sjroficd; that this permit docs not grant any <br />authority todo work or activities requiring wparatc permit approvals: and <br />that ihisprrmitdocsnoigrantauthoritytovioiatcany provision ofany Gty <br />ordinance or State law, rule or rcgubiion. All work shall be done in strict <br />compliance with all City ordinances, building axles and/or health <br />department regubtions. and shall Iv subject to inspcaion. approval or <br />rejection by the City, Whenever so ordaed, the undersigned agrees to <br />correct any work found to he in viobtion t>f the amditions of this permit. <br />TOTAL <br />State Surcharge: <br />Total Amount Riid to City <br />Fee $___/■ <br />Fee $ <br />This permit is not valid until the proper fee is paid and it is approved <br />by an authorized City ORidal. <br />Signature of Applicant <br />fn^ <br />X <br />Code While—File Copy'Canary—Inspector’s Copy Pink—Finance Copy Gold—Applicant’s Receipt