Laserfiche WebLink
GENERAL PERMIT CITY PERMIT NO. 8057- <br />CITY OF ORONO Date <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner �- Mn-%�_ Address <br />Contractor Address ��d b / l7ZLJ� 8/,��(V <br />City License No. .mil State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />`r,Ll NEW <br />❑ ADDITION <br />❑ REPAIR <br />Inside Plumbing (##fixtures_) <br />Fee <br />S <br />Water Well <br />Fee <br />S <br />Water Meter (Size—) <br />Fee <br />S __ <br />Mechanical Equipment <br />Fee <br />S <br />Meter# <br />Remote# <br />Moving /Lifting Buildings <br />Fee <br />$ <br />Municipal Water Connection <br />Fee <br />S <br />Land Alteration (Excavation, <br />Fee <br />S <br />❑Copper Q <br />Grading, Filling, etc.) <br />Municipal Sewer Connection <br />Fee <br />S _ <br />Fire <br />Fee <br />$ <br />❑ PVC ❑Cast <br />0_ <br />Sprinkler System (Fire) <br />Fee <br />S <br />MWCC SAC Charge <br />Fee <br />$_ -- <br />Other: <br />Fee <br />S <br />On Site Septic System <br />Fee <br />S 57 00 <br />After -the -fact Investigation <br />Fee <br />S <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges receipt of this limited <br />Permit. including acceptance of all special information, <br />terms, conditions or requirement 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 specined: 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 />Pant authority to violate any proAdon of any City <br />ordinance or State law, rule or regulation. All work stall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shell be <br />sublect to inspection, approval or refection 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 permit. <br />Signature of <br />TOTAL <br />State Surcharge: Fee I _ �y <br />Total Amount Paid to City Fee $1 <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature 9PUity Official <br />Code: White cy Canary-tnspector's Copy Pink - Finance Copy old -Applicant's Receipt <br />