Laserfiche WebLink
GENERAL PERMIT CfrY PERMIT NQ 9142 <br />CITY OF ORONO <br />PO. BOX 66 Date <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner 1' ) _ Address <br />Cottttact(. ktn 11�d- (,J �' / JOv Address <br />City License No. Q City / `4 / I <br />REMARKS AND SPECIAL CONDITIONS <br />n . , <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures —) <br />Water Meter (Size _—) <br />Mt ter # <br />Remote # <br />NEW <br />re: $ <br />Munici Waterion Connect <br />Copper ❑ _ — <br />Municipal Sewer Connection <br />Ya PVC ❑ Cast ❑ <br />MWCC SAC Charge <br />On Site Spetic System <br />ACKNOWLEDGEMENT <br />Fee S <br />❑ ADDITION <br />Fee C%v <br />Fee S C'u <br />Fee S <br />Fee S <br />The underagtned herrtn at knowiedgec reveilrt tr( this limited permit. <br />inc-tiding nxxpurxY tit all %rxcal mkxmau:m. term.. xidiu,ro tx <br />rNwrertx,,..s written abow rht arikin ned urdmtaneis and agrees <br />under remit cot law that this permit is anttly limited in scone U, the sstxk. <br />attisit) tx tmprnsement 9voriied. that this F met dtx.., rdtt grant a+,y <br />sutlx'ntvtndowtxk ractisttiesreytanmi <br />ngwriaratepertapprose6,and <br />than pd(x'% not grant atghmliit) %v*tcam, pnrsitawc{amCii% <br />txdrtarxe tr State late rule tr reprlatitxt All Mirk shall he done to strict <br />comrWrx-e with all City twdirtomm huikttng txxes . t.Utr health <br />department regulaurm.. and shall 1- "kw'—t 'nspecti m; apprnsal or <br />rret urn by the Cit,, Wherw%er sit order,' undcrvgned agreve• w <br />evxrttt am wtxk krurd to he to mAstWn t e t crdiu.rts ofthts permit <br />Signature of A icant <br />Water Well <br />❑ REPAIR <br />Mechanical Equipment <br />Fireplace/Wood Stove <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Design Review <br />Fire <br />Sprinkler System (Fire) <br />Other. <br />After -the -fact Investigation <br />TOTAL <br />Mate Surcharge: <br />Total Amount Paid to City <br />❑ REMODEL <br />Fee S _ — <br />Fee S <br />Fee S _ <br />Fee $ <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee SZ,� <br />Fee $ 6 1 ' 60 <br />0-16- L 1 61-;, � <br />Tiris permit is not valid until the proper fee is paid and it is approved <br />by an authorized City Official. <br />Signature of City Offitial <br />0 010 <br />Cede White- File Cop, ('anan lmrirctdr's Cups <br />link—Fnarim Copy Gold— AppWw's Receipt <br />