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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO.7771 <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />Date <br />Owner "T t in )C /Address -j< ,j (JL ^0 i; ^-/ ■ T^f J <br />Jt r\^Contractor . <br />City License No--------------^ <br />0L <br />V <br />L ') )v V- j /.'jO 0/ / » )./ AV^r/ <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />V^c<~ k ■7f-.4 0 <br />PERMIT TYPE AND FFR: <br />Inside Plumbing (Iflxtutes ----) <br />ft NEW □ ADDITION □ REPAIR <br />Fee S <br />Water Meter (Size/o' <br />Melerf <br />Remote * <br />Fee ^ OC <br />Municipal Water Connection <br />Dcopper rn <br />Fee S <br />Municipal Sewer Connection <br />□ pVC Dcast Q <br />MWee SAC Charge <br />Fee S <br />On Site Septic System <br />Fee $- <br />Fee $_ <br />Water Well <br />Meclianual Equipment <br />Moving /I itting Buildings <br />Land Alteration (Excavation, <br />Grading. Filling, etc.) <br />Fee S- <br />Fee S_ <br />Fee S_ <br />Fee S_ <br />Fire <br />Sprinkler System (Fw) <br />Other;_____________ <br />Fee S, <br />Fee $ <br />After-the-fact Investigation <br />Fee $_ <br />Fee S__ <br />ACKNOWLEDGEMENT <br />Th« MnetrW—#4 Mnkv acknowMaH iM*v. of IMa ltaHa4 <br />aaialt. taclw4ki4 ataaeiaaca a* 41 leaatil MtaMattaa. <br />laoM. cosilttaAa at la ^ilia iflt »4Hw ahoaa. TWa <br />irni—*■-— Uit4»rtMi4i M4 tpaoa aMtor paMltv ol Uar <br />lhat ao* etfinu U Mtadt kMia ak !• mof* W «M woth. <br />acttvily at tmetoataiH iptaW ti; Ibal 44t ptnaW 4oaa <br />4M fpaal a«» tMaotia to 4a oratk ot actMMoa ttkoMat <br />a»4Matt MilBit a 44»a»4«; 0*4 Mat 44t vamu 4oat aol <br />grant tM*<Hltr to ttotera mr ptowMoa al any City <br />atatitanct ot Stata Ittt. raia at ragiilaltaa. A4 wotk *a« ha <br />4om tai tMct cMpHoiMa itMk 41 CHt itHara m. hiill4las <br />eo4n Mi4/ot ha4«b 4urafi «t tagiilaMaat. ts4 4i4l ha <br />MMatt to kiigatgan. tgptaa4 at rat a egao hv *t Cttv. <br />Srhan tyat to at4tta4, 4w Mg4tralvta4 affaaa to conatt <br />•ay wotk foM4 la ha M Halagoa a* 4m «o«4IMa«a al <br />gritaataiU. <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S_____ <br />Fee t ^ <br />This permit is not valid until the proper fee it paid a«d <br />it U approved by an authorized City OfTicial. <br />Sigm^MC of Applicant^ __ _ j <br /><( vr'ivw <br />( Signature of City Official <br />> *'- .J. ilO (r'c) <br />■/ <br />(u4t ftliiit nkrupy Ctaar) teipsttui^ CoR PiKli Himc« Coff 1