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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NV 8706 <br />P.O. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />Date "’SU <br />Owner lih /T/^e/n 'eJkji <br />Contractor <br />City License No. <br />Address <br />Address <br />City _ <br />C\ ■ <br />REMARKS AND SPECIAL CONDITIONS^-S <br />p) Inir t f <br />I <br />*-< <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (^fixtures _ <br />\Mtter Meter (Size___) <br />Meter#__________ <br />□ NEW <br />Fee $ <br />□ ADDITION □ REPAIR □ REMODEL <br />Fee $ <br />Remote# <br />Munid|ial Witer Connection <br />□ Coooer □___ <br />Fee $ <br />Municipal Sewer Connection <br />□ PVC □ Cast □ <br />MWCC SAC Charge <br />On Site Spetic System <br />Fee $ <br />Fee $ <br />Fee $ <br />Water Well Fee $ <br />Mechanical Equipment Fee $ <br />Fireplace/Wood Stove Fee $ <br />MoNing/Lifting Buildings Fee $ <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Design Review <br />Fee S <br />Fee $ <br />Firp F p ^ .t <br />Sprinkler System (Fire)Fee S <br />OrhiH-.f <br />After-the4act Inve^igation Fee $ <br />TOTAL <br />State Surcharge:Fee $ <br />Total Amount Raid to City Fee $ <br />> <br />ACKNOWLEDGEMENT <br />The undtfMintd heftb> tcknowleitfcs recdpl of this Itmiled pcnntl. <br />intludini aarpcinor nC alt sfvcial infonnatiofi. Itnm. conditions or <br />requirrments wntvn above. The undersi|Ened understands and aficts <br />under pmali> nl law that this permit is stnctly limited in to the wtirk. <br />acti\it> (H impnnement speciTutl that this permit dues not grant an> <br />authontv to do work or activities ftquinni vpaiaie permit approvaK: and <br />that ihtv permit does not grant authority lo violale any pmvision ctanv City <br />ordinancY or Stale law . rule or irgulation All work shall he done in strx't <br />compliance with all City ordinances, building auks and/or health <br />depanment regulatiom. and shall he suhfeci to inspecinm. appmval or <br />a*jecUon hv the City ^hTiencver so ordered, the undersigned agrees to <br />cxvrreci any wivk fiHind to he in violation ol the amdiuom of this permit <br />o25::£P <br />This permit is not valid until the proper fee is paid and it b approved ^ > <br />by an authorized City Official. <br />Signature Applicant <br />Z/iJi'i/u^ /Pl/AL Signalktt|rc^^iity Official <br />( txJe While I lie Copy Canary- Inspeclor’s Copy Pink f inaiKT Copw (kdd -Applicants Receipt