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GENERAL PERMIT CITY PERNIlT �o s 71� <br /> CITY OF ORONO <br /> P.O.BOX 66 ��Q /� ' ��r �� <br /> � CRYSTAL BAY,I��IINNESOTA 55323 <br /> (612)473-7�7 <br /> Owner �� Addre� �� 1 c� ���l' � <br /> Contractor � �f' - /L � i�r'l7�/1.91`31 � <br /> aadr����I7'l ° °� A�� <br /> c�ty r.���No. a o� I �1�, �-or�� ��ed <br /> REMARKS AND SPECIAL CONDTfIONS <br /> o (�� �� �� 3c�-�� �'��(�l� � " <br /> PERMIT TYPE AND FEE: � NEW ❑ ADDITION ❑ REPAIR ❑ REMODEL <br /> Inside Plumbing(#fixtures ) Fee $ Water Well Fee $ <br /> Water Meter(Size ) Fee $ Mechanical Equipment Fee $ <br /> Meter# Fireplace/Wood Stove Fee $ <br /> Remote# Moving/I ifting Bu�dings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration(Excavation, <br /> Grading,Fi7ling,etc.) Fee $ <br /> � ��r � I�.sign Review Fee $ <br /> Munici al Sewer Connection Fee $ ��•�� <br /> Fire Fee $ <br /> PVC ❑ Cast ❑ <br /> CC SAC Charge Fee $ Sprinkler System(Fire) Fee $ <br /> Other. Fee $ <br /> On Site Spetic System Fee $ <br /> After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> State Surcharge: Fee $ ' � <br /> The u�ersigned hereby acknowl�re�eipt of this liatited permit, ���(� <br /> including acceptance of all special information, ternis, condifions or Tota1 Amount Paid to City F8E $ <br /> requirements written above. The undersigned understands and agrees <br /> under penalty of law that this pemut is stricdy limited in scope to the work, <br /> activity or improvement speci6ed;that this permit does not grant any <br /> authority to do work or activities requiring separate permit approvals;and <br /> that this permit dces notgrant authority to violate any provision of any City <br /> o�a��a�e or smce�w,rule or regulafion.All work shall be done in strict '�permit is not valid unt�the proper fee is paid and it is approved <br /> compliance with all City ordinances, bw7ding codes ac►d/or health b 8II au�lOt1ZCC�Cl �Cl�. <br /> department regularions,and shall be subje�t to inspec;tion,approval or Y tY <br /> rejection by the Ciry.Whenever so ordered,the undersigned agrees to <br /> correct any work found to be in vialaGon of the conditions of this permit <br /> Signature o�licant <br /> � Signature o .City O�cial <br /> s���!, � <br /> Code: White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />