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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />CITY PERMIT NO. 8225 <br />Date At 5 JcS <br />Owner ( A LVVA�94A n r i aL Address 24 ZD -L)un ,� 1 Q,%i —= <br />Contracler Address /0/0 (t, rr i C �k.r� ,�/�y � <br />�5! �3 <br />City License No. State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />!2,0r) '1 e_fr VW_ -AA __fit RST 50 ZX AO �yt- C l� d <br />:l�-tER SD. _ 21 . 30 f N Res IEvJ <br />PI.e <br />_(Ays- ESE ycEy +d CFNTkA-L_ ALARM <br />PERMIT TYPE AND r EE: ❑ NEW ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) Fee S <br />Water Meter (Size —) <br />Meter # <br />Rem(, Le #' <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper rl <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Caac n <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />r Well <br />echanical Equipment <br />oving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />System (Fire) <br />Fee <br />S <br />Fee <br />S <br />Fee <br />$ <br />Fee <br />S <br />Fee <br />$AMIML <br />Fee <br />S ! 24. 30 <br />Fee S rAfter-the-fact <br />ther:�'N eiIe-W Fee S 46.15 <br />Fee S Investigation Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />permit Including acceptance of all special Information, <br />terms, aonditions o& requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that this permit to strictly limited in scope to the work, <br />activity of Improvement specified; that this permit d as <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 provtdun of any city <br />ordinance or Stale law, rul- or regulation. All work shall be <br />done In strict eomptlance with as City ordinances, building <br />codes and/or health department regulations. and shall be <br />1116ieet to lawoution, approval at rekerion by the City. <br />Whenever so ordered. the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />this pett,.it. <br />Signature of Applicant <br />1U Ir'] <br />Code: White File Copy Canary - InWKtor'sCopy <br />TOTAL <br />State Surcharge: Fee S - Sn <br />Total Amount Paid to City Fee S IRI .15 <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sip- 'Ure Of C 1 al <br />If j'4AArK&. <br />Pink -Finance ,opy Gold -Applicant's Receipt <br />