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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />CITY PERMIT NO.”. 762^1 <br />Dale <br />Owner Isvi/ccr. C.<f,Address,3/a <br />L^A i fe/fcfev A,ldr.-., u/. '77 g- 0/vu^Se^ <br />City License No ________________________________ State License No ------------------------------ <br />REMARKS AND SPECIAL CONDITIONS <br />u// RP 3/r/p3 <br />r <br />PERMIT TYPE AND FEE:^NEW □ ADDITION □ REPAIR <br />Inside Plumbing ( fixtures )Fee s._On Site Septic System Fee <br />Water Meter (Size t Fee $Water Well Fee <br />Meter #Mechanical Equipment Fee <br />Remote # <br />Municipal Water Connection <br />K <br />Fee Moving/Lifting Buildings Fee <br />^HCopper n------Land Alteration (Excavation.Fee <br />Grading. Filling, etc.) <br />Municip^ Sewer Connection X t*Fee % cK) <br />UCI DV/Z' ( 1 1 1 Other:.. - FeeJQIrVC LJvaHl <br />MWee SAC Charge Fee After-the-fact Investigation Fee <br />• I <br />! I <br />u <br />J <br />i <br />ACKNOWLEDGEMENT <br />Th# undtnLaiicd htttby •elmawtodiM fc^lpx of this Umiud <br />Including occopunet of aO ipoclal Information, <br />UfBU, conditions or rtqulstnianu wdlUn abevt. The <br />undritigiitd understands md agraas under penalty of Uw <br />that thb permit U strlcUy IlniUad In scope to the work, <br />activity JT Improvemant specified; that this permit does <br />not grant any authority to do week or activlUas requiring <br />separata permit approvaU: and that thU permit does not <br />grant authority to vtoUU any provUlon of any City <br />ocdlnance o' SUte Uw, rule or rtguUUspi. All work shaD be <br />done In stict compliance with eU Qty ordinancea. building <br />codee and/or health department leguUdons, end diall be <br />sublect to Inapectloo, approve! or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be In vioUtlon of the conditions of <br />this permit. <br />ature of Applicant <br />TOTAL <br />State Sureharge: <br />Total Amount Paid to City <br />Fee S. <br />Fee S Ml <br />This permit is not valid until the proper lee is paid and <br />it is approved by an authorized City Official. <br />Signature of City^^ <br />Code: White-IHe Copy Canwy-linpectnr’iCopy Pink lininceCopy (lold Applicenl'i Receipt <br />% <br />^ i