Laserfiche WebLink
t <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />CITY PERMIT NO. 8196 <br />Date l r i 1 0 15 <br />Owner S Address <br />Contractor dress <br />City License No. - 1 ate License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) <br />Fee S <br />Water Meter (Size—) <br />Fee S <br />Meter# <br />Remote # <br />Municipal Water Connection <br />Fee S <br />❑Copper n <br />Municipal Sewer Connection <br />Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge <br />Fee S <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Ire <br />kler System (Fire) <br />ther: <br />•-7� r-' U <br />Fee SI. After -the -fact Investigation <br />The undersigned hereby acknowledges r. •ipt 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 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 not <br />Omni authority to violate any provision of any City <br />ordinance or State taw, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />sublect to UmMeetion, approval or rekction by the City. <br />Whenever a0 ordered, the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signature of Applicant <br />TOTAL <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />State Surcharge: Fee $ <br />Total Amount Paid to City Fee S <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 Offfc/i <br />Code: White -File Copy Canary -Inspector's Copy Pink -Finance Copy Goid-Applicant's Receipt <br />