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GENERAL PERMIT CITYPLRMIT NO. 8484' <br />CITY OFKORONO Date -66 j�a�i9RW, <br />CRYSTAL BAY, MINNESOTA 55323 <br />(61')473.7357 <br />Owner,,/,y� as g r Y r l L - kj Address !��s C/]�1 l / '1w jJ� r . <br />Contractor R[-�'��✓- Address —710CJ11/71r7s\ <br />City License No. C` -I YL State License No. Zue- rz2 <br />REMARKS AND SPECIAL CONDITIONS <br />Seo 1 , pa kr —.`U M13A CS— °W)21 9I'lI n +r, OX0Imo. Yr J1n <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing Ofixtures—) Fee S <br />Water meter (size _) Fee S <br />MeterN <br />Remote 8 <br />Municipal Water Connection Fee S -_— <br />❑Copper 11 <br />Municipal Sewer Connection Fee S ....__ <br />❑PVC ❑Cast E- <br />MWCC SAC Charge Fee S <br />On Site Septic System Fee <br />ACKNOWLEDGEMENT <br />The uo-oovrd aemb, aam ledsea t—Wt of xu umued <br />o -1t, Nduo.. rwp.— nl W Wedel Nlo[m.am. <br />n&Iunpaml. w zvoto ante w.l.. .hare. The <br />.tot ondenl.na..nd .wee undo[ omit, ul le. <br />Np Nu pe,mll I. [ttletly unuua In mope to We vwk. <br />tin" w bolo -1 enl pecltlea. th.t at. p--,' awe <br />to. p.nl .1 .uNvdlr to du n'ork see ¢Yduu repro... <br />t,1-1.pprovW.. —dW.t NI. P-11 doe. n <br />p.nt mNntl6 to NW.0nn to—o nl 0., <br />wpn.n use Iv, rule ol.rvYuon. Au work .bas b <br />tlone N[.Wel`[omW.nve viN al urdm.n huadln{ <br />.uw'wnhenen.n.r.entrdl- p.welmo,oio.0nn.. -d .n . <br />to, N[ l <br />whmoa. .1 oo .d .ee. Imo. <br />a. <br />.k mono —httl—o1 me on..... n1 <br />tw ve.mit <br />Signatu �tlF'AgPlicant 1 <br />c -ah . (}Z <br />'moi t <br />Bier Well <br />rchanical Equipment <br />wing /Lifting Buildings <br />and Alteration (Excavation. <br />Grading, Filling, etc.) <br />IT <br />ainkler Syystem (Fire) <br />her: I& OGM <br />'ter -the -fact Investigation <br />TOTAL <br />Fee S <br />Fee S <br />Fee 3 - <br />FCC 3 - <br />Fee S <br />Fee S <br />Fee S / <br />Fee 3 - <br />State Surcharge: Fee S_t..Lv <br />Total Amount Paid to City Fee 3 (]0e's.Z <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />of City <br />CuY:"ift-ra[Copv Cuoor morwl."cmy Mnk els{erACap Gda-Aypn[{nt'. a[mpt <br />