Laserfiche WebLink
GENERAL PERMIT CITY PERMIT N° 914 3 <br /> CITY OF ORONO <br /> P.O. BOX 66 Date �� �3��� <br /> CRYSTAL BAY, MINNFSOTA 55323 <br /> (612)473-7357 <br /> Owner ' I Address ��a- � �� � ��C�`e - <br /> Contractor � � Address �' � ' � I <br /> City License Na � f `7 � City /l/<1�.(�Q�1'�►�2— ��Cf � <br /> REMARKS AND SPECIAL CONDITIONS <br /> a., -e..vJ o�� ) <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 Buildings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration (Excavation, <br /> ❑ Copper ❑ Grading, Filling, etc.) Fee $ <br /> Design Review Fee $ <br /> Municipal Sewer Connection Fee $ <br /> Fire Fee $ <br /> ❑ PVC O Cast ❑ <br /> Sprinkler System(Fire) Fee $ <br /> MW CC 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 $ <br /> The undersigned hereby acknowledges receipt of this limited permit, � � <br /> including acceptance of all special information, terms, conditions or Total Amount Paid to City F'00 $� <br /> requirements written above. The undersigned understands and agrees <br /> under penalty of law that this permit is strictly limited in scope[o the work, <br /> activiry or improvement specified; that this permit does not grant any <br /> authority todo work oractivities requiring separate permitapprovals;and <br /> that this permit does not gran[authority to violate anV provision of any City <br /> ordinance or State law,rule or regulation.All work shall be done in strict This permit is not valid until the proper fee is paid and it is approved <br /> compliance with aIl City ordinances, building codes and/or health <br /> department regulations,and shall be subject to inspection,approval or by an authorized City Offieial. <br /> rejection bV the Ciry. Whenever so ordered.[he undersigned agrees to <br /> correct any work found to be in violat�n of the conc�itions of this permit. <br /> Signat Applicant <br /> Signatur f rty Official <br /> �� <br /> , � <br /> i <br /> Code: White File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanPs Receipt <br />