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GENERAL PERMIT CITY PERMIT N? 8745 <br />CITY OF ORONO <br />P.O. BOX 66 [gate <br />CRYSIAI. BAY, MINNESOTA 55323 <br />(612) 473-7357 C/�rt' // �}- h c �/ Alk <br />Owner A( L <br />— --- Address <br />ContractorQ/_' Address <br />City L.ic�ense No. t0 UVJ City <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures ) <br />Water Meter (Sim �) <br />Meter # <br />Remote # <br />Municipal Water Conner <br />❑ Copper ❑ _ <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast U ._ <br />MWCC' SAC Charge <br />On Site Spetic Ssxtem <br />ACKNOWLEDGFMENT <br />T I t I I r t -1101 0 <br />NEW ❑ ADC <br />Fee S <br />Fix $ <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />IN- under,Wnd hcrch% ackntwltdgm rnetpt ttf this limited permit. <br />tniudtrtg aatptame rd all sptyy; mkwrnation. ternm ctwtdnatns tw <br />eyutremenn wntlen Ant IV unempned understands and altimN <br />urtder renal% d law that this permitn strw-d% hmird m gnttc ht the work. <br />Astons t% rmprtww"L•m %Iwifted. that this permit toes nit grant am <br />authonts Aida wtwk or acusttea rc4111n119 •c•Itaratr ptrmiutpprosak. and <br />that thn prrmtt dies n t gram auttk nt% u, tittlar ans prosiwtwt dam ('ns <br />Zinarwr or State law ruleto rep uldtion ll wore hit h• don to -Arkt <br />.ompltane with all ('us ordtnanct,. hudding .tsk, and'cw health <br />delwnmcm regulatiom and %hall Ie %uhtsri to insproi4m, approsal or <br />reKrnon ht the ( lt% WhCriew vt twdend the undetagned agree, w <br />a,r rrt r am work found to be in t u datttwt td Iht• . onditu tm d thts per mit <br />Suture of Ap licant <br />HTION O REPAIR <br />Water Well <br />Mechanica! Equipment <br />Fireplace/Wood Stove <br />Moping/Lifting Buildings <br />Land Alteration (Ex(avation. <br />Grading, Filling, etc.) <br />Design Review <br />Fire <br />Sprinkler System (Fire) <br />Other. <br />After -the -fact Inwstigation <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 />SD <br />lit4tl Amount Paid to City Fee !• <br />This pernut is net valid until the proper :cc is paid and it is approved <br />by an auth067LIJ City Official. <br />Signature of City Offiial`� <br />('ttdc U htte file tops Canary-- Inspector's Copy Pink– lFinanie Copy (Sold—Applicant's Receipt <br />