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E <br />GENERAL PERMIT <br />CITY OF ORONO <br />PO. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612) 473-7357 <br />Owner <br />Contractor -ae <br />City boense No. I `, <br />REMARKS AND SPECIAL CONDITIONS <br />-1:-x i <br />CITY PERMIT N? 8781 <br />Date -- _ ll o <br />Address ' —�'/ 0 / <br />Addrem- — 1 <br />City <br />PERMIT TYPE AND FEE )6 NEW O ADDITION <br />Inside Plumbing (fixtures ) <br />Fee 5 <br />Water Meter (Sine ) <br />F.Ve S <br />Meter # <br />Remote hi— <br />Municipal Water ConneLtion <br />Fee S <br />❑ Capper ❑ <br />Municipal Sewer Connection <br />Fee S <br />❑ PVC O Cast O <br />MWCC SAC Charge Fee S <br />On Site Spetw System Fee S <br />ACKNOWLEDGEMENT <br />lite urkl"ned hertbt ackrm -AWM rarq+t of thr, lunued riermil. <br />irOudrng aarrNarkc .d all .potvl mlorrttauon. termw o•ndtm-m tr <br />requirement% untt•n ahne The unrlr•ntgrkd undcr4ands and Agire• <br />under Renal" of law that tht, rwrmu t. ark.tlr Irmord m -wort• b• thr Nur►. <br />at11%11% tr tmrxutrnknt %rtetfrth, that tht� rtermn drt� rk4 Frtnt an) <br />au0kvn1% it, do Ntrk rk acrotic+reywnnrt rrwrate (xrmu aprruk:rk and <br />thaIIN% permit dot. ntgk <br />grantauthont%.%udalram prort.ronufan%Cu% <br />ordrrrrwc or tick• law. r uk rr rrguhruon All v.tkk Dull R• dtnk to .tn t <br />armplmme Nuh all l w onhnarkt� building otkY And of health <br />dernnment regulaturr.. and •hall be .uhrttl in tmrwoon. approral t•• <br />intron M N- Co W'hencte, w, ordered. the and r.rgrk-d agrm, to <br />corrcrt am wtak I.,urtl to1+r m tk 1au.rt.J Ik umrlmom.d thr. rwrmtt <br />Water Well <br />r <br />O REPAIR <br />Mechanical Equipment <br />Fireplace/ Wood Stove <br />Moving/Lifting Buildings <br />Land Alteration (Excavation. <br />Grading, Filling. etc.) <br />Design Review <br />I -2f" <br />Sprinkler System (Fire) <br />Other. <br />After -the -fact Investigation <br />0 <br />❑ REMODEL <br />Fee S <br />Fee S <br />Fee S <br />Fee S <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 S i� <br />Thi,, fx rmit 1s not %slid until the proper fee is paid and it is appro%ed <br />M an authonied ('its Official. <br />Stgnalu ' of A , runt <br />Signature of Cite Official <br />('tile W hue Mk• Co fn C 8rtar% In%p&-i(w'c Cop% Pink- t•inana• l -p% ' iokl Aprtltutnt'� Recerpl <br />