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GENERAL PERMIT
<br />CITY OF ORONO
<br />P.O. BOX 66
<br />CRYSTAL BAY, MINNESOTA 55323
<br />(612) 44}733--7357
<br />Owner L! J''L
<br />Contractor Co
<br />Cite License No.
<br />REMARKS AND SPECIAL CONDITIONS
<br />PERMIT TYPE AND FEE:
<br />Inside Plumbing Ofixwrt:s
<br />Water Meter (Si/e.---)
<br />Metef a ---
<br />Remote V —
<br />Municipal Water Connl•ction
<br />❑ Copper ❑ - —
<br />Municipal Slower Connection
<br />❑ PVC ❑ Cast ❑
<br />MN CC SAC Charge
<br />On Site Splotic System
<br />ACKNOW LEDGEM E114T
<br />�f N IAV
<br />Fee S
<br />Fee S
<br />CITY PERMIT N? 8823
<br />Date Tr.�
<br />Address D !. SCLC t %OUJ /C -OI
<br />Address ---
<br />City
<br />❑ ADDITION ❑ REPAIR
<br />Fre S .._.------_.-.--
<br />I-ce S __---.-
<br />Fee S - - ---
<br />Fee S --.—
<br />Ili• nmk-f%Wntt'd Meeh% a— bJpc+ m'opt u( tht. Itmrkd rmfi rt.
<br />ukitdtng aivriarkt• of all %rw wl mfircrmmnt 4mt%. oWiltnn. ,w
<br />:4tutemems wnUen tN,%v The untletwterkd urklerntand, and eFrce.
<br />under "Itvd Iaw that tht, lkcnnn!, drwth hmnrJ in vnpr u,the wnrk.
<br />;nmm or tmpnownx•nt .jv.tfttl. that the, tknad J,k•, MN gram any
<br />autM,nIN Kinn work ,I I,LvU,� v,junink v-puntr rwinntapl,n,,;d..tnd
<br />thaIth,,r rmtldootit-Ivran,amh„nt,I,,,,nlak-ampnuno,n,dam(uv
<br />„rdmark-,' nr Swc U1 rid, nr repulauon All work Kill N ,h,n• to irk
<br />,nrttpltarxc with all (lt, „rhnan.t� hutkhry .nJt, itkl ur hcdlh
<br />departmt•nt «-Fula* . n. aril .hall h, .til-wo to m.lkl Utm. appr,,,al ,rt
<br />n•pi tkxt ht the ( it% %%licne,t!-nrdertd. tht• utx..-wx',l arTo, to
<br />,nen•,t.rn% t,..rk Inmkl toM in ,r, lannn the.,nxlal. m i It,,, perrnrt
<br />Signature of Applk3nt
<br />Water Well
<br />Mechanical Equipment
<br />Fireplace/ WN)d Stone
<br />Moping/Lifting Buildings
<br />land Alteraticn (Ext;avation.
<br />Grading. Filling, etc.)
<br />Design Revxw
<br />Fire --
<br />C REMODEL
<br />Fee S—�
<br />Fee S
<br />Fee S —
<br />Fee S
<br />Sprinkler Ssstem (Fire).
<br />Other: -_ 4 / C o- —
<br />Mter-the-fact Insestigation
<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 ? fJ`�
<br />Total Amount Paid to City Fee S�
<br />This permit is not valid until the proper fee is paid and it is approved
<br />by an authorized City Official.
<br />nattuq of City Official
<br />Oak Whar I•fle Ctyn Canan Imptoor', Cop% Ihnk Finanw Ccgn Gait--AppkI M's Reaeip
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