Laserfiche WebLink
GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />C IT PE RMIT NO. _ _ 7120 1 <br />Date V/"? VT3 <br />Owner Address <br />LL' n <br />Contractor �%Qi� ��_ Address <br />City License No. State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND 1 F: 0 NEW ❑ ADDITION <br />Inside Plumbing( # fixtures ) Fee <br />ev <br />Water Meter (Size S ) Fee S %S <br />Meter # 2 z . C-�6e1 <br />Remote# 034 /437Z <br />ev <br />Municipal Water Connection Fee S= <br />❑Copper ❑ <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee S_ <br />The unde si ined hereby acknowledges receipt of this limited <br />Permit. including acceptance of all special Information, <br />terms, conditions or requirements written above. The <br />undetmgned understands and agrees 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 ,f any City <br />ordin&M, or State law, rule or regulation. All work shall be <br />done In strl:t compliance with all City orctinances, building <br />codes and/or health department regulations, and shaU be <br />subkct to inspection, approval or refection by the City. <br />Whenever so ordered, ,hr undersigned agrees to correct <br />any work found to he to %iulatlon of the conditions of <br />this permit. <br />Signature of Applicant <br />Codc White rile f opy Canary Inspecittr's Cupy <br />❑ REPAIR <br />On Site Septic System Fee S <br />Water Well Fee S <br />Mechanical F-lrmpwent Fee S <br />Moving/Lifting Buildings Fee S <br />Land Alteration (Excavation, Fee S <br />Grading, Filling, etc.) <br />Other: Fee S <br />After -the -fact Investigation Fee S <br />TOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fer�- <br />This pennit is not Nalid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />is <br />Pink i inamc Copy Gold Applicant's Receipt <br />