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Owner <br />Coniractor <br />City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />Lay)ol ma rtc ■ <br />REMARKS AND SPECIAL CONDITIONS <br />Address. <br />f)on Address <br />____________________City <br />CITY PERMIT N9 8856 <br />Date <br />/yi /o <br />'he Olc^c?/ C Uy <br />PERMITTYPE AND FEE: <br />Inside Plumbing (^fixtures ) <br />Walter Meter (Size ) <br />Motor H <br />j^^NEW <br />Fee S <br />Fa* S <br />Romnto H . . <br />Munidpal Wetter Connection <br />□ Copper □ <br />Fee S <br />Munidpal Sewer Connccrion <br />□ PVC □ Gist □ <br />Fa* S <br />MWee SAC Charge Fee S <br />On Site Spetic Sjstem Fee S <br />□ ADDITION □ REPAIR □ REMODEL <br />Water Well Fee $ <br />Mechanical Equipment Fee $ <br />Fircpiacc/Wood Stove Fee S <br />Moving/Ijfu'ng Buildings Fee S <br />Land Alteration (Excaration, <br />Grading, Filling, etc.)Fee $ <br />Design Review Fee $ <br />Fin»Ft><» $ <br />Sprinkler System (Fire)Fee $ <br />Ollipr Fee $ <br />After-the-fact Investigation Fee $ <br />TOTAL <br />State Surcharge;Fee $ <br />Total Amount Paid to City Fee $ <br />ACKNOWLEDGEMENT <br />The undefMgned hereby acknowledges receipt of this limited permit, <br />including aavptance t>f all .s(xxul informaiinn. terms, additions rx <br />requirements written aNwe. Tht undersigned understands and agrees <br />under (vnaliy of bw that this permit is strictly limited in verpv to the work, <br />actisiiy ix imprownKnt spxificd; that this |x*rmit does not grant any <br />authority lodowork oractisiiics requiring separate permit approsak anil <br />that this permit d* not grant authority to \iob te any prousion of any City <br />ordinance or State bw. rule or n^mbuon. All work shall be done in strict <br />wmplbncc with all City ordinances, building codes and Ax health <br />department regubtions, and shall be subject to inspection, approsal or <br />rejation by the City. Whcncscr so ordered, the undersigned agrees to <br />C'lrravt any work found to be in sir4ation i>f the conditions of this permit. <br />Hu's permit is not valid until the proper fee is paid and it is approved <br />by an authorized City Official. <br />Signature of Applicant <br />Signature of City Offidal / ) <br />CckJ l*: While—File Copy Canary—Inspector ’s Copy Pink—Finance Copy Gold—Applicant’s Rcoript