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GENERAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY. MINNESOTA 553:3 <br />(612)473-7357 <br />Owner `)r ' I `� L1 L t Lr L <br />t <br />Contractor A- t . L v _- <br />City License No. OIL <br />—_ <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 8548 <br />Date � I/./ <br />t <br />Address l �i �,JI C's C, Il -t <br />Address <br />State License No. (J u t I h rA—U-x y I <br />LA <br />>►� tf' t r 1 > t I I l�' <br />�Lt1,•4utV ir.► ► tet a ►yet <br />PERMIT TYPE AND FEE: I NF.W ❑ ADDITION ❑ RI IrAIR <br />Inside Plumbing (41fixtures_1 Fee S lWatrr Ncll <br />Water deter ISise_1 Fee S -__ Mechanical Equipment <br />Meter/ <br />Memotted 1 \luring ILiflingBuildings <br />Munrtipal water Connection Fee S _ _ __ Land Alteration (Excavation. <br />[Copper n (trading. Filling. etc.) <br />Municipal Sc% r Connection Fee I ire <br />❑ PVC ❑(-ast rl-. tipnnklel S%�Ie.11 IFlrel <br />MWCC SAC Charge Fee S (nl,er <br />-s� <br />On Site Septic System Fee S Attrr•thr-I lel Investigation <br />ACKNOWLEDGEMENT <br />The und.rogn•d 11—ht e, kn...:.dp. —tpl of thn 11—ted <br />yelntlt. including —Pt— 'd .11 .p.rral minnnaunn. <br />"Vu1r. m.nU ."I"ab. e. The <br />end. rogn.d .rude"land. and .u... und.r P—SAV al la. <br />Ib.t th,, permit :. tint Uy 11m1Ud In .cope to the wurlt. <br />s.b.tly r.+ 4npro..mmt .pntfled. that flit. permit dues <br />n..l giant an. autl-rlty In do %urk or ac U.Itlaa "Quinn{ <br />..pante peen It a.rpro, ala, and that Nu permit dues not <br />{rani vu Utonly to violate any protlelun of any CIN <br />.xlhllal.ce nr %I.t. 4a. rule m "galallun. AO murk h.0 he <br />dune In .tn.t rompharue .1th 10 Clty ordinance., ti i.1"g <br />rodes tmdlor health departraent "N4Uon:, and .hall be <br />eublect b lr"pec Uae, gppe.»al of "MrYoa by the City. <br />Wheae.er w -doped. the undersigned q"eo to aur"ct <br />an•. swIt f.wnd to be . .Iolati— ul the eon fill .m of <br />thl. pemtlt. <br />MII A plicanl <br />t i <br />TOTAL <br />St.ite <br />OTAl- <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fre <br />S <br />Fee <br />S <br />Fee <br />S <br />State Suriharl:e. Fee S �l <br />Intal .%mount Paid to City Fee S i� <br />i <br />1111, pennit is not valid until the proper fee is paid and <br />It a approved by an authorized City Official. <br />Signature City Official <br />Ca k NUM- Hk Can clary - Impectag'g can Matt-Flluaa Copy COM-ARNMtlt R&*t <br />