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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(§1 21) 473--7357 <br />Owner <br />Contractor <br />City License No <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEF.: ❑ NEW <br />Inside Plumbing (#fixtures_) Fee S <br />Water Meter (Size—) Fee S <br />Meter# <br />Remote # <br />❑ ADDITION <br />Municipal Water Connection Fee S <br />❑Copper n <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast El- <br />MWCC SAC Charge Fee S <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee 5 <br />Thous, , , hereby seltnowledw "coot off fbe Vmlted <br />PSrmlt, Indudins ao"Issm" of IN well Infoemwon. <br />eralel emotions or neufr mme Wats." .bow. The <br />undersigned undentands and gPeu under Mndt7 of low <br />Shot the oeemit is sWeW Valued In .POPS to the wort, <br />activity or hnorovement wolfed: Isms " Permit dose <br />Not puns any wthoor to do work or sesivid" noutiins <br />esvasae PSrwlt boeoeoe: end that Wk Permit does net <br />RMS Mthodr so ulnae ars sroyYlon of My Cit# <br />ardinewAs or VINb low. rue or "Wetiaw. AN work " be <br />dose In dries eomsWdee with an Qr mrlleMora, bulldee <br />eede and/or boom dwmtmMt egdNer. and dial be <br />.oboes to htrpeeOM. agtovd or elnstlon M the City. <br />srMnever so unkind, the undndswed We" to 9oreel <br />My work found to be is Violation of the 900411110" of <br />the Pemdl <br />CITY PERMIT NO. 82331 <br />Date —� (J , I <br />A(' C�(�'%'t / i r ( I <br />Address &§15— �� <br />Address <br />State License No. <br />❑ REPAIR <br />ater Well <br />echanical Equipment <br />oving /Lifting Buildings <br />Ind Alteration (Excavation. <br />Grading. Filling, etc.) <br />re <br />Irinkler System (Fire) <br />ther: <br />iter -the -fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee S <br />Fee S 1 <br />Fee S 1 <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />This permit is not valid until the proper fee is paid and I <br />it is approved by an authorized City Official. <br />Signaturef f City Official <br />Cude While I ile Copy Unary iepacer-s Cope nak-1•heew Cepr-ApOcawtti RMW <br />