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GYRAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owneroe <br />Contrnctor <br />City License No.—i— <br />REMARKS AND SPECIAk. CONDrI IONS <br />L <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (#fixtures �) <br />Water Meter (Size —) <br />Meter # <br />Remote # -- <br />Municipal <br />_ <br />Municipal Water Connection <br />O Copper ❑ <br />M Sewer Con on <br />❑ Cast ❑ <br />MWCC . AC Charge <br />On Site Spetic System <br />ACKNOWLEDGEMENT <br />O NEW <br />Fee S <br />Fee S <br />cin' PERMIT N° 9076 <br />Address <br />Address 12 <br />� 1 ) <br />City1. <br />❑ ADDITION O REPAIR O REMODEL <br />Fv - S <br />Fee S�50 <br />Fee S <br />Fee S <br />ilk undcr,4prkd hcnhs "fu,%kdltc, moix of this limited rwrmtt. <br />including aau•ptanc �d all .tt»:tl tnfrKtnatkm. terms. a ndrUrms or <br />reywienkms %Morn aNrsc The undcrsignd urk -rund, and agree, <br />urxkr penahs r l law rhai the, prrmn n -Ancil) lumkd in worw ur the work. <br />now% rK improsrment yrcrrird. that this rwrin t der, not grant an, <br />authonq totkr wrxk or acinnM, requiring wparak permit apprmak and <br />ilmi the, prrmn dr rtes nw gram audknts w sit lase am p i m-4tn edam Cm <br />r._ wduwncv or Sisk law rule ry rrgulatin All wixk dull N• don• to %lmi <br />u"riliance with all Cm iwt4mamcs. Naklrng 0xk•, and to tkahh <br />dqunment wpulamm,. and Jell he suhteo to tmprtlun. appro,al or <br />rritt'urn hs the ('ns wfie"r%er mi wdered. ilk- undersigned agar, to <br />cornet an% work found to N• in su4niun 10 tN• sonlmons 4 this riermn <br />Signa rc�eif Applit�nt - <br />a 7 <br />Ctttk: %hitt• File Cally <br />Water Wsll <br />Mechanical Equipment <br />Fireplace/ Wood Stove <br />Moving/Lifting Buildings <br />Land Alteration ( Excavation. <br />Grading. Filling. etc.) <br />Design Review <br />Fire <br />Sprinkler Svstem (Fire) <br />Other. <br />After -the -fact Investigation <br />Fee S <br />FeeS— <br />FeeS— <br />FeeS— <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />TOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee 5: <br />This permit is not valid t.nui WC proper fee is paid and it is approved <br />by an authorized City Official. <br />Signature of ( W-O(1'iL <br />Canar% In,.Mitx', (op} Pink hnanr Ct" Gukl--Applicator's Mado <br />