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GENERAL PERMIT ��P�� N� s o s s <br /> CITY OF ORONO <br /> P.O.BOX 66 �� 6/19/8? <br /> CRYSTAL BAY,MINNESOTA 55323 <br /> (612)473-7357 <br /> Owner pouqlas Demaliqnon Addres.s 1380 Arbor Street <br /> Contractor Sullivans ��� Hwv 101 <br /> City License No. City Wayzata, MN 55391 <br /> REMARKS AND SPECIAL CONDITIONS <br /> SAC pad 6/19/87 — Permit #9067 <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/Lifting Bw7dings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration(Excavation, <br /> ❑ Copper ❑ Grading,Fi7ling,etc.) Fee $ <br /> Design Review Fee $ <br /> Municipal Sewer Connection Fee $ 3(�.-0 0 Fire Fee $ <br /> � PVC ❑ Cast ❑ Sprinkler System(Fire) Fee $ <br /> MWCC SAC Charge Fee $ <br /> Other. Fee $ <br /> On Site Spetic System Fee $ <br /> After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> State Surcharge: , Fee $ .5 0 <br /> The undersigned hereby acknowledges r�eipt of this limited permit, 3 0. rJ 0 <br /> including accephance of all special information, terms, conditions or Total Amount Paid to City FP.e $ <br /> requirements written above. The undersigned understands and agrees <br /> under penalty of law[hat this permit is strictly limited in scope to the work, <br /> activity or improvement specified;ttiat this permit dces not grant any <br /> authority todo work oractivities requiring sepatate permitapprovals;and <br /> that this pertnitdces notgrantauthority to violate anyprovision of any City <br /> ordinance or State law,rule or regulation.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 ordi�nces, bmlding codes and/or health b an authorized Ci �1C1�. <br /> department regulations,and shall be subject to inspection,approval or y ty <br /> rejection by the City.Whenever so ordered,the undersigned agrees to ' <br /> correct any work found to be in violation of the condibo�s of this permit <br /> Si ture of Applicant <br /> „ � �� Signature City Official �� <br /> . , <br /> Code: White—Fi'le Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />