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1 GENERAL PERMIT <br />CITY OF ORONO <br />CITY PFRMIT N® 9034 <br />Owner <br />P.O. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612) 473-7357 <br />Dace <br />|[j X* ).(_* <br />i Contractor C.O. <br />Citv License No.<A«y <br />■J <br />REMARKS AND SPECIAL CONDITIONS <br />______! ' /) 7 4 yi r t <br />PERMIT TYPE AND FEE; <br />Inside PlumNng (ttfixtures _ <br />Witer Meter (Size___) <br />Meter#__________ <br />□ NEW <br />Fee S <br />Fee $ <br />0 ADDITION <br />>^ter Well <br />Mechanical Equipment <br />Fiicplaa*^WxxJ Stove <br />□ REPAIR <br />Remote # <br />REMODEL <br />Fee $ _ <br />R» $ _ <br />Munb'pal MVbter Connection <br />□ Copper □ ___ <br />Fee $ <br />Municipal Sewer Connection <br />□ PVC □ Oisl □ <br />MWee SAC Charfe <br />On Site Spetic System <br />Fee $ <br />Fee $ <br />Fee S <br />Mo\ing/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading. Filling, etc.) <br />Design Review <br />Fire________________ <br />Fee S <br />Fee $________ <br />Sprinkler Svstem (Fire) <br />Other ___________ <br />After-the-fact Investigation <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee S <br />Fee S <br />Fte S <br />ACKNOWLEDGEMENT TOTAL <br />State Surcharge; <br />riif umkr^^fik'd horrhy lcllnlHlcll^^ uvopi iif ihis limiktl pcimii. <br />iihiuJinit «.vcpuncr »if all «|wial infiicnulMHi. icnnv condimim <» <br />rrquircnk*'L5 i^nticn aNnt. The underMgncd underMand^ and agrees <br />under penally nClau ihaiihis pcrniii is Mrictl> limiied in lothc Hork, <br />•cti\iiy nr imprmcmeni specified: that ihis (xrmiii dtA> nta gninl an\ <br />aulhoniv lodo I^ork or activities rcquinng Hrptnile permit apprenak and <br />that this irrmi! tkxs n»< gram authoniy to violale anv pnntMon i^anv (*iiv <br />ordinance or Stale fan*, nilr or regulation An work vKall he dom- in stnci <br />comphanct lanh all City ordinances huiklirig uJes and or health <br />department regulauonv and shall he subject to iRNpcciMirs approval »h <br />rc|alion by the Ciiy ^k’henever w ordered, the undersigned agrees to <br />twrcet anv work found lobe in vitiation t4 the condlnor^ i»f this permit <br />Signature of Applicant <br />Total Amount Piid to City <br />Fee $ * ^ ^ <br />Fee $^/O.6<0 <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 Citv Official <br />Jsj <br />('ode: Vk hilo File Copy Canat) lnspccit)r\ Copy Pink Finanev ('opv Ciold- Apf4icant's Receipt