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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO.7t23 <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />Date <br />Owner <br />Contractor—^— <br />Address c^F7/ /€?V <br />City License No. <br />?lc\r.tn ^dda’SS <br />State License No. <br />REMARKS AND SPI CIAL CONDITIONS <br />f-i rep k\o -_____/ 7^^./e /-C <br />/ M:’ /e //; 1 y/ry-n-'7 <br />77 <br />PERMIT TYPE AND FEE: □ NEW □ ADDITION □ REPAIR <br />Inside Plumbing (#fixturcs —.)Fee $ <br />Water Meter (Si/e —) <br />Meter#_______ <br />Fee S_ <br />Remote if <br />Municipal Water Connection <br />D Copper n <br />Fee S- <br />Municipal Sewer C«)nnecti»)n <br />□ PVC □ Cast Q <br />MWee SAC Charge <br />Fee S <br />On Site Septic System <br />Fee S <br />Fee S. <br />Water Well Fee $ <br />Mechanical Eipiipment <br />Moving /Lifting Buildings <br />Fee % <br />Fee S <br />Land .\ltcration (Excavation, <br />Grading. Filling, etc.) <br />Fee $ <br />F'ire <br />Sprinkler System (Fire) <br />Other;_____________ <br />After-the-fact Investigation <br />Fee S <br />Fee $ <br />Fee S <br />Fee $ <br />ACKNOWLEDGEMENT <br />The ufi^nigneil h«i»by •cluiowttdai»« rvee^t of tlilt ttmtUd <br />pennii« jneinding acetgtoiiee of hD tafotmatloii, <br />ieims, ccMUlltftoiia of itquirein«fili wiititii AlMwt. The <br />iinilfnignTi iuid»r«t*ndi and agiwot undtt pMiattr of low <br />ihot tido ponnli ii •trielly Umitod in icog« to di« wotli, <br />acUvitir or iinprov»in«fil gp^ifled; diol Alt pomiit dons <br />aty» garni ony authority to do worh or ortivtiiot loquMnd <br />«tpnrot0 iterwit opprovtlt; and that IfcU pofmtt dom not <br />gront nudioilly to vtoUlo anv groHdon ol «iy City <br />ordhuMcc or %%mi» Uw. role or roguUllon. AS wotli dinS bo <br />dont in Btrict compliomo widi oB City ordlnMinoB, bnildtng <br />eodu Md/ot hooIBi doportmont mgiBlntloM. «mI duS bo <br />nibjoci to fnopf^tion. appfovot or ptfooilon by dr# City. <br />Wbonovtr to or ^^d. dio nndoNtgnod odPOOi to ronoot <br />•ny x*ori found u» bo in ^iolnfion of dir rondidoM of <br />fhiB prrDul, <br />Sign^ire of Applicant ^ <br />TOTAL <br />State Surcharge:Fee t 0 <br />Total Amount Paid to City Fee I <br />This permit is not valid until the pn^r fee it md <br />it is approved by an audtofued City Official. <br />Signature of City Official <br />CiMk dhilt idot opy Conory biynt tor"t Copy KhkriBdMCapy Gda <br />j