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General permit <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL. BAY, MINNESOTA 55323 <br />(612)473-'’357 <br />CITY PERMIT NO." 6604 <br />Date /^ ^ ^/ <br />Owner ' Address ^ ^0 D ____________ <br />Contractor fi \Al LLJ^^ ^L ajl^ Address ^ S <br />City License No. State License No. . _______________________ <br />REMARKS AND SPECIAL CONDITIONS <br />/ev,ooo tMU <br />PERMIT TYPE AND FEE:□ NEW □ ADOmON □ repair <br />Inside Plumbing ( # fixturrs,_)Fee s On Site Septic System Fee <br />Water Meter (Size_)Fee S Water Well Fee <br />Meter § <br />Remote # <br />Mechanical Equipment Fee <br />Municipal Water Connection Fee $__________Moving/Lifting Buildings Fee <br />D Copper D____Land Alteration (Excavation,Fee <br />Grading, Filling, etc.) <br />Municipal Sewer Connection Fee S <br />n pvc n Cast n Other:Fee <br />MWCC SAC Charge Fee $Afte^the-fact Investigation Fee <br />ACKNOWLEDGEMENT <br />Th« unimMpMd hmbir aduiowliddM nc«ipt of OUi limited <br />ptmitt, iMliidlBg oaoapteBeo of «U modal tetonnattoii. <br />teima, eoBdMoM or roauiiomonto wdUea abovo. Tha <br />dgaad uadonteado oad amooa uadar poaalte of law <br />teat tela paoait ia atriater tealted la aaopo to tea woafc, <br />activity or taaptovanant madflad: that thla poonlt dooa <br />aot paat aay auteoilty to do wetk or aetivittoa aomtelaa <br />aopaiate panalt aporovala: aad teat tela paaalt doaa aot <br />gtaat auteoilty to violate aay proddoa of aay City <br />nriiaaana or State law, lula or lafulatloa. A1 work teall ba <br />dooa la atdet eompHaaaa with all aty ordteaoaaa, bulldlog <br />aodao aad/or haalte dapmtmaat laeulatlooa. aad tedl bo <br />auWaat to teapaatloo. adprovd or lalootloa by tea aty. <br />Wbaaavar oo ordaiad, tha Modaidgiad ago it to coma t <br />aay work fouod to ba la vlolatloo of tha eooditlooa of <br />thlayocmlt. <br />Signature of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee « <br />Fee « 3.0. SO <br />This peimit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of City Official <br />Code: White-File Copy Guiaiy-lnipector’t Copy nak-Finance Copy Gold-Applicaat't Receipt