Laserfiche WebLink
GENERAL PERMIT CITY PLRMIT NO. _-6775 <br />CITY OF ORONO Date <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner Address _ ...,,� 4o <br />Con tractor rl% 4-e-4 �i, Address C <br />t <br />City License No. State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE. <br />Inside Plumbing ( # fixtures <br />Water Meter (Size ) <br />Meter # <br />Remote # <br />❑ NEW XADDITION <br />_) Fee $ <br />Fee $_ <br />Municipal Water Connection Fee $ <br />❑ Copper Q <br />Municipal Sewer Connection Fee $ <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee $ <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all special Information, <br />terms, conditions or requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that thla 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 nct <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes n11/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 be in violation of the conditions of <br />this permit. <br />Signatu of AP licant <br />r <br />,REPAIR <br />On Site Septic System Fee $ aJL <br />Water Well Fee $ <br />Mechanical Equipment Fee $ <br />Moving/Lifting Buildings Fee $ <br />Land Alteration (Excavation, Fee $ <br />Grading, Filling, etc.) <br />Other: Fee $ <br />After -the -fact Investigation Fee $ <br />TOTAL <br />Sv� <br />State Surcharge: Fee <br />Total Amount Paid to City Fee $ <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 Oft)0al <br />Code White file Copy Canary Inspector's Copy <br />Pink - I inance Copy <br />(wrid Applicant's Receipt <br />