Laserfiche WebLink
GENERAL PERMIT CITY PERMIT NO.--6878I <br />CITY OF ORONO <br />P.O.BOX 66 Date _ <br />CRYSTAL_ BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />I <br />Owner G . Address S % z� • ! <br />Contractor W'11� _d - Address � <br />City License No. State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />,�_l1 U t <br />PERMIT TYPE AND FEE <br />Inside Plumbing ( # fixtures <br />Water Meter (Size ) <br />Meter # <br />Remote # <br />❑ NEW UADDITION <br />Fee $ <br />Fee $ <br />Municipal Water Connection Fee $ <br />❑ Copper ❑ <br />Municipal Sewer Connection Fee11 $ <br />❑ PVC ❑ Cast ❑ <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Other: <br />Fee $ i After -the -fact Investigation <br />'he undersigned hereby acknowledges receipt of this limited <br />Lrrmit, including acceptance of all special information, <br />terms, conditions 3r requirements written above. The <br />undersigned 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 />@operate permit approvals; and that this permit does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. Ali work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department 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 ba• in violation of the conditions of <br />this permit. <br />Signatu • of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee <br />$ 210 - 06 <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ <br />Fee $ <br />Fee $ABC <br />This permit 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 Canary Inspector's Copv Pink- Finance Copy Gold Applicant's Receipt <br />