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GENERAL PERMIT <br />UITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />Owner nern�. <br />Contractor �� /? ,� r � C/ F_x C <br />City Limn No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE XNEW <br />Inside Plumbing (#fixtures ) Fee S <br />Water Meter (Size _—) Fee S <br />Meter # <br />Remote # <br />Municipal %ter Connection <br />❑ Copper ❑ <br />Municipal Sewer Connection <br />APVC ❑ Cast ❑ <br />MWCC SAC Charge <br />On Site Spetic System <br />ACKNOWLEDGEMENT <br />Fee S <br />CITY PERMIT N? 8734 <br />Address KW .� f e S � am" <br />Address 2.2 o V crwon s <br />City k 4!:� re-71 114 k) <br />❑ ADDITION ❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Fireplace/Wood Stove <br />h1oving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Design Review <br />Fee S <br />Fee S <br />Fee S <br />fltr undersigned hereby acknowk m reeapi d this limited permit. <br />incldinit aLuTtance of all special irformawn. terms. conditions or <br />rNLiremem written mast. T%e understitnnl understands and agrees <br />under penaliv of law that this permit is gristly limited in scope to the work. <br />amity or improserrmrnt specified ihat this permit daes rat gent any <br />autfanty todo work or actisities requnng separate permit apprsah: and <br />that this permit does not p -,no a udxmty to Ciolate anv prImmon d any ('ity <br />ordinance or Sate law. rule r r regulaom. All work still he done to print <br />Compliance with all City ordi antes. building cedes and -'or health <br />department regulauceK and shall he subject to impmlion. approsal or <br />rejection by the City Wheoestr rk ordered. the urderdgned agree, to <br />correct ans work hxxd a, ne con sinhaoon ma the conditions of kits permit <br />Signat of Applicant^ <br />Fire <br />Sprinkler System (Fire) <br />Other. <br />After the4act Investigation <br />❑ REMODEL <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />TOTAL <br />State Surcharge: Fee S 1 S� <br />Total Amount Phid to City Fee S 30, Sb <br />This permit is not valid until the proper fee is paid and it is approved <br />by an authorized City Official. <br />City Official <br />Qide: White- File Copy Cann Inspectors Cops Pink— Finance Cop) Gold-- Appliant's Receipt <br />