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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO.7728 <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(6I2)47.V7357 <br />Date <br />Owner <br />A (6l2)47.t-7357 s?^7/ <br />Contractor _ Z.4-L <br />City License No. <br />Address <br />Address <br />(hj^d mTjf <br />4 ’H^ AJtOtUd ~ Mph.. <br />State License No. <br />remarks and SPECIAL CONDITIONS <br />^- /i^ftLL L ciJ Ofi/) 4u I f\()aa <br />h~ tiHh Jni^ <br />l~ yihii\Lo i\ <br />PERMIT TYPE AND FEE:□ ADDITION □ REPAIR <br />Inside Plumbing (#ti\tan*s—) <br />Water Meter tSi/e —) <br />Meter# <br />Fee S <br />l•■ce S <br />Water Well <br />Remote # <br />Municipal Water Connection E'cc S□(opper <br />Municipal Sewer Connection <br />□ pvc DCast Q <br />MWee SAC Charge <br />On Site Septic S>stem <br />Fee S - <br />Fee $ <br />Fee S. <br />^lechanical Equipment <br />Moving /Lifting Buildings <br />Fee S <br />Fee S <br />Fee S <br />/iCAj <br />Land Alteration (Excavation, <br />(trading. Filling, etc.) <br />Fee S <br />Eire <br />Sprinkler System (Fire) <br />Other:_____________ <br />After-the-fact Investigation <br />Fee $. <br />Fee S <br />Fee $ <br />Fee $ <br />ACKNOWLEDGEMENT <br />TNr und#rit«ii*d hfiwbif wpknowkdi^t rwctkpl of HiAs lAinilod <br />tiicludlikt oec^pionc# of ail i^ociol kifoimolloa* <br />itofint. coiMlIlloiu Of loqMifviiianU wdttoA atevo. Th« <br />yiidonlinad inkkratonoa aod am— uodar of law <br />ttiat taUi poBinlt U ftficthr Umitod ia tcopa tolM wotb. <br />activity m iwptovmgfit ipoclfkad. Ibal iMa iMiaut doa« <br />Ant ^raat anv aMdicMtty to do monk or acMvIllaf rtquirted <br />••pwate patwilt aippfovwlt. and teat tela pmawlt doM not <br />9ant aateoftty to vto&ata mr provtteon of mw City <br />lAtenanrf or dtnla law. ruW or rafulaUon. Al work teaB W <br />dona te tlrtrt e«>mplianca wite all CUv ard tean rai , teiildted <br />andaa and/or Iwaltli danartanant tapila tiona. and teaB tei <br />Mteaet to taapactlon, apnroaal or itlactten bt tea Cilf* <br />Wbanaaof ao iwdarad. tea yndarteanod aflwaa to cofract <br />anv wnrii fwnd to ba in violation of tea eondllialia #»f <br />teia patwiil <br />s^ipyturcjjtA^pUcar.t <br />a <br />/ <br />TOTAL <br />State Surchaige: <br />Total Amount Paid to City <br />Fee S <br />Fee <br />■ SO <br />This permit is not valid until the proper fee is paid mti <br />it is approved by an audiorized City Official. <br />SignatMe of City OtTici <br />V Ik M fU) <br />Co4tf nt» fnw < lMf« »e«'i Coa»Pkah i Co»»GoU af^vMI*ll9CWt