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GENERAL PERIVIIT CITY PERMIT NO. <br />CITY OF ORONO <br />P.O.BOX 66 Date <br />CRYSTAL BAY, MINNESOTA 55371 <br />(612) 473-735 7 <br />Owner Address <br />Contractor Address <br />City License No. k tx4l Q State License No. <br />K_ . oalk-d Feed <br />REMARKS AND SPE.. AL C NDITIONS <br />,4_'s I.A e 1 1• <br />& O 6 (.►-c, /. <br />PERMIT TYPE. AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing 4fixtures._) Fee S <br />Water Mett:r (Size) <br />Meter# <br />Remote �► <br />Municipal Water Connection <br />]Copper Q-_ <br />Municipal Sewer Connect <br />❑ PVC ❑Ca,. <br />MWCC SAC Charge <br />On Site Septic System <br />Fee S—___- _—__ <br />Well <br />nical Equipment <br />oving /Lifting Buildings <br />S - _ <br />8148 <br />♦ 44-� est <br />jLanJ Alteration (Excavation, <br />Grading, Filling, etc.) <br />C <br />l'ce S _ ----- re <br />Fee S I <br />Fee S 1 <br />Fee S_ 9 <br />Fee S <br />Fee S_ E. <br />Sprinkler System (Fire) Fee S <br />Fee S _ - -- ther:[�?.rt Fee S S• <br />Fee SL ) <br />ileo -far Investigation Fee 5.... <br />ACKNOWLEDGEMENT TOTAL <br />The undersigned hereby acknowledges receipt of this limited <br />Pamil, inclu"a acceptance of all wocial Information, <br />term+, conditions or requireimens wdtten above. The <br />unde- g nod understands and agrees under penalty of law <br />that this penult is strictly iimiMd in eeope to the work, <br />activity or improvement sdacified: that tole permit does <br />not pant any authority to do work or activities requiring <br />"Paste Permit approvals: and that this persalt don not <br />grant authority to violate any provision of my City <br />osnaaanee or State law, rule or regulation. All work dull be <br />dome in strict compliance with all City wilYuncea, building <br />codes andlor heallis department regulations. and @Mall bs <br />mrbiect to inspection, approval at wiectiom by the City. <br />Whenever so ordered, tlne undersigned agrees to correct <br />any work found to be in %iolation of the conditions of <br />this pernit. <br />.iignature of Applicant <br />Cottle: While -File Copy Canary hnsm or'@ Copy <br />Surcharge: <br />Amount Paid to City <br />Fee $ /, O n <br />Fee S 1 J.00 <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Offiiciiai. <br />Signat re of City �dff' :nal <br />i <br />Mink -Finance Copy GftJ--AppNc@W s ttisdP1 <br />