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Home My WebLink About1982-6717 - 6 SAC charges , t i�� ,.��,,;-�� {;,, - . CITY PERMIT NO. 6717(a ,. ' =ir:;GEN�RAL P�RMIT � � z��rCITy p� ORONO Date 6-�3 "� �'�"#� � P.O.BOX 66 �^•�.,� . � �. �.. � . �"� '�. CRYSTAL BAY,MINNESOTA 55323 �,'j:; (612)473-7357 � � �,L, � `�' I ` /�� / � � /• ��.� . , �f ,�F ,, /,(/�� Qi Address �Owner �" , � � — /X��u�aaress `:contra�ta� ��:° `' State License No. City License No. - � ��,: � /r � *�REMARKS AND SPECIAL CONDITIONS � P ' � � r '.; ,3 � � 9 �� s � � _ Kj?�T; .t�:. . . • . . .. ' ik�:�.,, � .. � �/ fi a. .' � .. " . . . . , ... �.tpERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑REPAIR � ` On Site Septic System Fee S � �Iriside Plumbing( # fixtures ) Fee $ f';r; : . WaterWell Fee S _ "Water Meter(Size ) Fee $ � � � Fee� S � ;`. �. , -Meter # Mechanical Equipment ;��` -� ��:Remote# , Fee S ,, � . Moving/Lifting Buildings :>; Fee $ Fee S �Munic�pal Water Connection , Land Alteration(Excavation, '� � r::[]CopPei Grading,Filling,etcJ . =."��, ; . Fee $ Murucipal Sewer Connection p�e1: Fee S__--- � ,. �� ' CI PVC ❑Cast n----- c ��/� a �i��" � Fee Ss2�s� Afterthe-fact Investigation Fee S_.— �MWCC SAC CharBe ��t, „ , s ,�4�s , _ � � � TOTAL � .pC�CNOWLEDGEMENT ��5�•,� . . ed hexbY acknowledtes zecdDt of Wa limiled �',Y,,Th�uadad� �ceeDtance ot dl �D�d� intorm�tlon. Fee ��--- ,� ,.; vamis, m�Ya�s 'r�• State Surcharge: �'.`y 2 Fqmu.�'emdttions or :eV�menL wdttea ��• �.undeestands u►d �y undee P�� of Lw h� Er'taa:J mis vernie b .aicHr u.ni+ea 9a .00De to 11'ii ao: tY Fee S �� .;r :��a`� ��,�m�„t ,�n�a: ri►•s mi. v� Total Amount Paid to Ci ---�— w :'-:w�%ad'R�uC �n7 autAoYlb to do wark or aetivltles reQui:lnt >Ny�y ps�mit aVOrovds: md that t63s V�nnit doe� not �� t��p{ p�fLWitY'-to vlolate �nY VY�oa of �nY CItY ,�,� �� o=g��k��a o=re�ulatloa.All work�hvl be .I.h� pe�it is not valid until the proper fee is pa1 ' �r "°dow io afsleL compltmce with all Cit9 o:dfnmeas,buildlnt ''�';eoda md/os Walth.dtDarpnent ret�tloas. �nd shtll be �g�„�pyrov�t � rf��n�� br �Q �'t''• it is approved by an authorized City Official. .� �' ' .�'wtbl�ct to �aed. ths undsid��d �� coaeat , N/hanewi_w vtoLtlon of tl�e aoadltloas of �'� � anY woek fouttd W be 1n �,�,�. fhts Deemli '' ' Sign of City Official Si ature of A plicant �S ,;;:, � x �: !'; , . , � .. . . . .. . . 4 ' pink-1•'imnce CopY �%�d—APP�t s Reoeipt s h' Code:Whtte-1'i!e CopY CanuY l�►sPector:CopY _. Y � ��'� �p •�i�T �""�� . a ' y x%. Y ", �'r'�g ! h.3 C ,x•. � ..,_ ` '�,A�*.��y,ti��'r "+��3"!� t6 <'�;+' '�`.- t 3+ _ y�F �j '} � ;zv '� • „u(� �� x.e� '�+.0 Y `.a 'w-w. :�i«-.'�i;�'�r, t e� !n .,S e� ��t 4K 4�..;�`I t�*,`�° y� x,`l �.<<-� �