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I <br />GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO.8586 <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />Date <br />Owner____. <br />Contractor <br />f City License Nn. f ^-------------- <br />Address 55d^ vJ/iV. M. <br />Address l^^OL> 7 IHn <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE:fp NEW <br />> Inside Plumbing (ffixtures__) <br />Water Meter (Size <br />Meter#___ <br />I Remote #__ <br />J <br />Municipal Water Connection <br />OCopper ri <br />□ addition □ REPAIR <br />Fee $__________Water Well <br />Fee S-----------------Mechanical Equipment <br />Moving /Lifting Buildings <br />Fee S----------------- <br />Municipal Sewer Connection <br />□ pVC Gcast Q. <br />MWCC SAC Charge <br />Fee S <br />On Site Septic System <br />Fee S <br />Fee $. <br />Fee S <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee $ <br />Fee $, <br />Fee $. <br />' Fire <br />Sprinkler System (Fire) <br />Other:_____________ <br />After-the-fact Investigation <br />Fee $. <br />Fee $, <br />Fee $ <br />Fee S. <br />ACKNOWLEDGEMENT <br />Th« unitonttmd hcnby ■JknowtodfN raccipt of thto Uraiud <br />pcnntt. including aecoptancc of aO 9«clal tnfonnatton. <br />Ums, conditfona or nQuirtmmta written above. Tba <br />undarrignad undantenda and affaaa undar panalty of law <br />that thla paimlt U atitctly limited In aeopa to Uia work, <br />activity or improvamant dteciflad: that thla parrait doaa <br />not gnat any authority to do work or actlvitiaa raqulrlng <br />aapante paimit approvala: and that thia permit doaa not <br />grant authority to violate any provirioa of any City■mnwawnoo^ wwr -------------------- --- ------------ <br />ordiaanca or Stete law. rule or ragulatlt'n. AU work ihall be <br />* doiM la atriet compliaaca with all City ordlaaacaa. buildlag <br />eodaa and/or haalth dapaitnaat ngulattona, and ahall ba <br />I <br />______________________ngulattona,------------------ <br />aublact to taupaettoa. approval or niaettoa by the City. <br />Whanavar ao ordand. the uadaratgaad agnaa to comet <br />aay work found to ba in violation of the conditlona of <br />thla paimlL <br />L. <br />Signatur^f A^plicant^ ^ ^ <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $. <br />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 Official <br />•V* <br />Codt: Wklte-Hk Copy Cgaiiy-tavoctof'iCopy Pink-Finance Copy Gold-AppUcant*! Receipt <br />...a—