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GENERAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />Owrter l �< ► / ( to C'-��, 4a 11, ►moi <br />Contractor <br />City license No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE-- <br />Inside <br />EE <br />Inside Plumbing Ofixtures <br />Water Meter (Size —) <br />Meter At <br />Remote 4 — <br />Municipal Water C'onnecuori <br />❑ Copper ❑ <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast ❑ <br />MWCC SAC Charge <br />On Site Spetic System <br />ACKNOWLEDGEMENT <br />c•rn, PFRMIT N? 8752 <br />Date —4 , , vz 3_ IL <br />Adores, /I 6rea),) to -x <br />Address <br />City <br />❑ NEW ❑ ADDITION <br />1 Fee S <br />Fee S <br />Fes S <br />Fes S <br />Fee S 75. tuft <br />Fee S <br />ilii• urdmr ited hrrtirt u'kw %ktlpr, rttittpt 4 thi. Itmmd permit, <br />intuhnp xtrptamr ,d all tpxvl mhwmah,rn, wren,. ox fitwm ,. <br />rryurem mr wntkn ahwr IV undervpned urdrrwrwh and akmt, <br />under prnaltt ,e Ww that thn pvmn r urrtlt limited to wortr ul the w ork. <br />atvtnt ,a tmprotrmmi yaxdad. that the. permit hx, ma print am <br />auth,mtt Lod,+ wtwk or alntntrn n'tlunrlp Yparar permit appro%2k. amt <br />that thm premn d,n ma pqm stabs nit u, ntiar am protrwrn td an, ('itt <br />,wdmtmvtw%laklar rule,rrepulamrn All uiNk%hallbe Ll,Mrin ami <br />.nmpleme with all ('u% ,rRhritmx\ hurkhryt oxk� and ,w heath <br />tkpanmmt njpulatrtwn, and Jell he %uhjott to rmrmtr,m. approtal on <br />rcjeoum ht the (',I% whent•ne, wr wderad. the umkrvpmd aprtt. to <br />,otn%t an\ w,Mk Lruml I-, he In 4,Jah,, n 4 the Urndtmrw of the. permit <br />Signature (if Applicant <br />Water Well <br />❑ REPAIR <br />Mechanical Fquipment <br />Fireplace/WmA Stove <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Design Review <br />Fin <br />Sprinkler System (Fire) <br />Other. <br />After -the -tact Investigation <br />TOTAL_ <br />State Surcharge: <br />Total Amount Paid to City <br />❑ REMODEL <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />I'a s tin` <br />Fee S 6 <br />Fee S (47�;.sv <br />i <br />This permit is not valid until the proper fee is paid and it is approved <br />by an authorized City Official. <br />Signature of ity O" <br />oink Whne—Fie Copy Canan In%Mux%Copy Pink-FilrroeCopy GoW Apphcani%hemp <br />