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GENERAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612) 473-7357 <br />Owner EOwwa-b <br />Contractor S v,\ PV 0 — <br />CITY PERMIT N? 8765 <br />Date <br />Addrt-,s / 230 chce.vsoN <br />Address —_ L°/2P-.e T-0 <br />City License No. — _ City -- — _ <br />REMARKS AND SPECIAL. CONDITIONS <br />Fl ve (INe$- — a 43 FuAA)AC.-t <br />PERMIT TYPE AND FEE <br />D NEW <br />❑ ADDITION <br />REPAIR <br />Inside Plumbing (fixtures ) <br />Fee S <br />Water Well <br />Water Meter (Size —) <br />Fee S <br />_ <br />Mechanical Equipment <br />Meter a _ <br />Fireplace/Wood Stove <br />Remote # <br />Mo%ing/Lifting Buildings <br />Municipal Water Connection <br />Fee $ <br />Land Alteration (Excavation, <br />❑ Copper D _ <br />Grading, Filling, etc.) <br />Design Review <br />Municipal Sewer Connection <br />Fee S <br />— <br />Fire <br />D PVC D Cast D <br />Sprinhkr System (Fire) <br />MWCC SAC Charge <br />Fee $ <br />Other. <br />On Site Spetic System <br />Fee S <br />After -the -fact Investigation <br />ACKNOWLEDGEMENT <br />The undmtgned herehr acknowledgta rmetpt N this limiled permit. <br />(nludortg jurptanr of all spmvl information. terms, corw " or <br />rtNwrrmenLt ttntten aho .r The undervlened undemundt and agrn <br />under penaltN of law that tho permit (t an.tlo hmord m rope to me work <br />acuortr or imrwowment spn�tftel. that the, patina doer not grant ant <br />authomt�tudoworkorattontttirr4tanngseparatepermitapprt •3kand <br />that thn perms dies noa grant authomtt to • ioht am prnoivon (dam Cl(t <br />ordinance or State law, rule or regulation All Mork shall he dome in vnt <br />u(mplam-r with all ('ot% ortd(rtant%. hwkLng coidr and- or health <br />detartment rtgulauom.. ant ,.hall he auhwo to tmrecttom. apprttal or <br />relation ht the Cm Whenr.rr 41 ordered. the undera(gned agrem to <br />correct am work found to he in tt(Jauon of the tomdo,om of thn permit <br />Signature of Applica <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />❑ REMODEL <br />Fee S <br />Fee S Z s o <br />FeeS— <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S S� <br />Fee S 2,57 • SM <br />�11- jS 9,� <br />This permit is not %alid until the proper fee is paid and it is approved <br />by an authowed City Official. <br />Signature of City Offtciaj__ _ <br />Inl-� Jcl__��. <br />Code %%'hire hit- Corn Canso- Inspeuori Copy Pink f-tnance Cop% Gold Applicants Receipt <br />