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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55321 <br />(61') 473-73 7 <br />Owner Q • ' "' <br />04 <br />Contractor <br />City License No <br />RF MARKS AND SPI CIAL CONDITIONS <br />CITY PERMIT NO. 75504 <br />Dater -- I Id –94 <br />Address — )l ✓1 �.. <br />Address _„3&,n__ _ <br />--- State License No. -- <br />PERMIT TYPE. AND FEE: V-Nlt.W ❑ ADDITION <br />Inside Plumbing I N fixtures. 1 Fee S <br />Water Meter (Si e_) Fee S <br />Meter N <br />Remote N <br />Municipal Water Conne.ct�iica� � Fee <br />❑Copper ��, <br />Municipal Sewer Connection Fee b –A-1, L-'` <br />xPV_C ❑ Cast n <br />MWCC SAC Charge Fee SPA (l, <br />ACKNOWLEDC,EMENT <br />The uodrtvgned herebt as b. nu ledges reeelpt of this limited <br />pens ll, ol"t,ding accep Waw of W pedal information. <br />term., a.m dmons or re0uatments written slime. The <br />undersigned undrntands and agrees under parasols of law <br />that this permit I. stncdt limited In scope to the work. <br />avtiUti .,r unproaement specified. that that perms does <br />nod pent ani au Non" U, Jo work or acUsluee reyualn{ <br />separate permit apprm also and that this permit does not <br />pant wdh,,ntt to aLdale ant proalsun art ans l'It, <br />1,rch arlre or state law, rule or regulation all wort ahaa be <br />done in ~1 amore ralenre wad. W fits ordp.anae. budding <br />codas wd,.ke health department regulation•and shall be <br />subject to impeauon, spproval or releeuon bt the ('Its <br />W"heneser w -adered. the undersigned spree. t,, ,.,ne.I <br />on, work found to he in ata4uon nl the undlb�.na .r <br />this permll <br />_.___-_ --( ads •1tIM -1 sir 1 (sr+) 1 anises Iny.r. L., a 1 cops <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moiling/Lifting Buildings <br />Land Alteration 0 xcavation, <br />Grading, Filling, etc.) <br />Other: <br />After -the -tact Investigation <br />TOTAL. <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Stile Surcharge Fee SJ-- e <br />Intal Amount Paid to City Fee S <br />Ihls pennil is lout valid until tha, ptuper fa t, pied end <br />It is approved by an authonted City Official. <br />SignIll t lh Office' <br />pink t masiae (ay.t (atlal ApplutgN► tI <br />