Laserfiche WebLink
GENERAL PERMIT CITY PERMIT NO... 70221 <br />CITY OF ORONO Dat <br />.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(61 22) 473-7357 <br />Owner Kuri Address cUi0+`SAA e - <br />Contractor �lQ.��� eL(- Address F�DEti✓ QfA(L►(Z- KA --V% <br />City License No. State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE. AND FEE: XFW <br />Inside Plumbing ( # fixtures ) <br />Water Meter (Size ) <br />Meter # <br />Remote +� <br />❑ ADDITION <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast Q <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee S- <br />The undersigned hereby acknowledges receipt of this limited <br />parent, Including acceptance of all spec/al information, <br />tensa, conditions or requirements written above. The <br />undersigned understands and agnea under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity or improvement specified; that this permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals; and that this permit does not <br />grant authority to violate any provision of any City <br />ordinance or State taw, rule or regulation. All work shall be <br />dons In stilet compliance with W City ordinances• building <br />codes and/or health departaient regulations, and shall be <br />subject to Inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be to violation of the con tions of <br />this permit, <br />re o plican t <br />Code. White file Copy Canary Inspector's Copy <br />RI. ❑ REPAIR <br />On Site Septic System Fee S <br />Water Well Fre S <br />2000 <br />Mechanical Equipment Fee S <br />Moving/Lifting Buildings Fre S <br />Land Alteration (Excavation. Fre S <br />Grading, Filling, etc.) <br />Other: _ Fee S <br />After -the -fact Investigation Fee S <br />p0. <br />TOTAL <br />State Surcharge. Fee S.,Oro <br />� <br />Total Amount Paid to City Fee S.07Qis <br />This permit is not valid until the Prot . fee is paid and <br />it is approved by an authorized City (" <br />Signature of City Oftici <br />/ .. <br />Pink I finance Copy Gold Applicant's Receipt <br />