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GENERAL PERMIT
<br />CITY OF ORONO
<br />P.O. BOX 66
<br />C'RYSIAL BAY, MINNESOTA 5523
<br />(612) 47.1-7357
<br />r
<br />Owner
<br />Contractor
<br />City Limnse No.
<br />REMARKS AND SPECIAL CONDITIONS
<br />11 Lr -1Q[ i I ilr' / I I'l t , G1 -f
<br />r
<br />('ITY I'FRMft' N? 8632
<br />Date
<br />Addrecti
<br />Addre-,s
<br />ROA
<br />qvi ri
<br />yo�t c -7Si•,
<br />PERMIT I PE AND FEE: O NEW 0 ADDITION O REPAIR REMODEL
<br />Inside Plumbing Ofixtures Fee $ Water Well Fee S
<br />Water Meter (Size —) Fee $ —_ Mechanical Equipment
<br />Meter #
<br />Remote a —_
<br />Municipal Water Connection
<br />0 Copper O -
<br />--Municipal Sewer Connection
<br />O PVC 0 Cast O
<br />MWC'C SAC Charge
<br />On Site Spetic Svstem
<br />ACKNOWLEDGEMENT
<br />114• unLk*Mq 4d hcfch% acknowledge. nti,Yrt 1q th„ 11mrled rrrmrt.
<br />11471allllp auapmnLe ,d all Glx -,Lal Inr„rmau„n. term.*, %:u141m,m. IN
<br />mywrcmenu wn14•n ahrwr the ur4lervpri d ur4rerst " and apre"
<br />ur4k t prnaln ul taw Ihal Ihn Petmn n vrttlt hmt4d In4LAIV W the wr>rk,
<br />urr�nt rx Imprnenknt 4worwi. that th" flermrl tk4% nra pian an%
<br />au114,n1%4,dr,w4xkrttadrtn41% .Iwnnprepuarr"Milapprovah.and
<br />11YI IhhlrrmndtIe%mIlpramauthra:%h t-4sicam prmiwrtltt(am(',I%
<br />rmhnan r or Stair law full• to rrpulatp,n All wlxk %tall I4 drl4 m Vra t
<br />t14tI(trlar4e with all tit% ordinamm lituklrnp vmk� and or hcahh
<br />Alunmenl repulan,m, and %tall he kul eWo 4, m.�nlrn, aMxngl r4
<br />rr•I ikm h% the (',1� whemwr w, ordrrtd. the Ilr4lerVpned a;rlxc to
<br />uitem t am w„rA','Intl n, he m %411a1',V li the i,a4hp, n, IYl thn permit
<br />i
<br />'e of An,lkr im A
<br />TOTAL
<br />State Surcharge: Fee S • S
<br />C.`
<br />-16tal Amount Paid to City Fee S DCJ�
<br />This Permit is not %alid until the proper fee is paid and it is approved
<br />by an authorised City Oficial.
<br />I
<br />signal”
<br />° ►f Cily
<br />Of �—
<br />Fee S .—
<br />__Fireplace!W(xvi
<br />Fireplace W(xvi Stove
<br />Fee S
<br />Moving/Lifting Buildings
<br />Fee S
<br />Fee S -----_—_
<br />Land Alteration (Excmvation•
<br />Grading, Filling, etc.)
<br />Fee S
<br />Fee $
<br />Design Re%iew
<br />Fee S
<br />Fire ---
<br />Fee S
<br />Nee $ — -
<br />Sprinkler System (Fire)
<br />Fee S --_
<br />Fee S
<br />Other: --. _--
<br />`
<br />Fee S
<br />Alter -the -fart Investigation
<br />Fee S
<br />114• unLk*Mq 4d hcfch% acknowledge. nti,Yrt 1q th„ 11mrled rrrmrt.
<br />11471allllp auapmnLe ,d all Glx -,Lal Inr„rmau„n. term.*, %:u141m,m. IN
<br />mywrcmenu wn14•n ahrwr the ur4lervpri d ur4rerst " and apre"
<br />ur4k t prnaln ul taw Ihal Ihn Petmn n vrttlt hmt4d In4LAIV W the wr>rk,
<br />urr�nt rx Imprnenknt 4worwi. that th" flermrl tk4% nra pian an%
<br />au114,n1%4,dr,w4xkrttadrtn41% .Iwnnprepuarr"Milapprovah.and
<br />11YI IhhlrrmndtIe%mIlpramauthra:%h t-4sicam prmiwrtltt(am(',I%
<br />rmhnan r or Stair law full• to rrpulatp,n All wlxk %tall I4 drl4 m Vra t
<br />t14tI(trlar4e with all tit% ordinamm lituklrnp vmk� and or hcahh
<br />Alunmenl repulan,m, and %tall he kul eWo 4, m.�nlrn, aMxngl r4
<br />rr•I ikm h% the (',1� whemwr w, ordrrtd. the Ilr4lerVpned a;rlxc to
<br />uitem t am w„rA','Intl n, he m %411a1',V li the i,a4hp, n, IYl thn permit
<br />i
<br />'e of An,lkr im A
<br />TOTAL
<br />State Surcharge: Fee S • S
<br />C.`
<br />-16tal Amount Paid to City Fee S DCJ�
<br />This Permit is not %alid until the proper fee is paid and it is approved
<br />by an authorised City Oficial.
<br />I
<br />signal”
<br />° ►f Cily
<br />Of �—
<br />
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