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F <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner Y I n Q l p✓ �� n� vYlc� <br />Con"111" +G) o 1 C,_ <br />City Liceroe No. YL <br />REMARKS AND SPECIAL CONDITIONS <br />S ► -k--e (moms - <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures ) <br />Water Meter (Sine ) <br />Meter # <br />CITY PERMIT N? 8796 <br />Date <br />Address L� <br />Address�K �• <br />City <br />N <br />*NEW O ADDMON O REPAIR <br />Fee $ Water Well <br />Fee S Mechanical Equipment <br />Fireplace/Wood Stove <br />Remote M <br />Municipal Water Connection <br />Fee $ <br />O Copper O <br />Municipal Sewer Connection <br />Fee S <br />❑ PVC ❑ Cast ❑ <br />MWCC SAC Charge <br />Fee S <br />On Site Spetic System <br />Fee S <br />ACKNOWLEDGEMENT <br />The unlermptned hcrrhy a-krr,piedga rmvipt of thi% Itmtied permit. <br />trxhaling accelu v tit all %prcial information. tcrmc. oxtdiuom or <br />reytrremrnl% AMorn ahr,%e Pit utrlmlenr d untimunds and agret, <br />under penalty of lap that Ihi%permit m Arxll % limited in wow to the work. <br />a-tmly tx tmfxo%rmem %pwrtrd: that the% permit dtx� not grant any <br />audxxity todn =t tx allr%tmm retltannit %rparar permit apprmah: and <br />Ihatthis pemildi sntNgramaudxxitytowilatramprowmrndanyCit} <br />ttrd.nonm tx Sine lap. rule tx tvTulation UI p(xk ;hall hr done in WWI <br />txxnpliartce with all City onlinonces. hulthrtg ctxln and/or beam <br />department rqulatrort%, and %hall ter %t*Wct to inspection. amwmal or <br />rr)r txvn by the City whene%er .t, ordered. the unlrrvgned aptt-� to <br />oxmy an% pork found to he to %rt dauttn ttf the condition, ttf this permit <br />Signature of Applicant <br />Moving/Lifting Buildings <br />Land Alteration (Excavation. <br />Grading, Filling, etc.) <br />Design Review <br />Fire <br />Sprinkler System (Fire) <br />Other. <br />After -the -fact 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 $ <br />TOTAL L <br />State Surcharge: Fee S - <br />Total Amount Paid to Ci!y Fee S S.X� <br />This permit is not valid until the proper fear is paid and it is approved <br />by an authorimd ON Olfrcial. <br />Signat of Cltv OlTrctal <br />Coda. Whir— File Copy Canary--InspeclW% Copy <br />Pink —Finamv Copy Cxttd-- Applicam's Receipt <br />