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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 I <br />Contractor LCj/ <br />City License No. t 21 `�2 <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />*•NEW <br />Inside Plumbing (#fixtures —_) <br />Fee S <br />Water Meter (Size —) <br />Fee S — <br />Meter p — <br />Remote q __ <br />Municipal Water Connection <br />Fee S — <br />❑ Copper ❑ — <br />Municipal Sewer Connection <br />Fee S <br />❑ PVC ❑ Cast ❑ <br />MWCC SAC Charge <br />On Site Spetic Systc-tt <br />ACKNOWLEDGEMENT <br />❑ ADDITION <br />Fee S <br />Fee v7s-, OV <br />Pie wkwimt ed ht.et» ackmwkt*g rt-in +i f thn limited permit <br />i->L;udmtlt na:epwtrtc td all apervl tnformauou. termw condor n, tx <br />rrytatrmenU wnrsn afire Tlk untervgned urJrr%Urnh and agree, <br />un ei rvnalh d law that thte permit is vrwtlt hrtttr:d to colic tat the work <br />aoi%it� tw mlco.rmrnt yxcil"wd. that thn rtcrmtt tkes ntw grant ant <br />."Nirttt, (tldtt wlNk tx atlt\ttrt regwnng rrarar permit ap ptovak and <br />that thtarermttdt,�nnttgrant authtwttNlotxdaramrctwiwin4anvOrr <br />onhrarwr or lute taw. rule tw retrulawm All work shall he tkww in urtet <br />Lumpirane with all Cit% ordinotrtcm. hwkrtrg c .-k, ardlm health <br />depanrt rnt regulawww and shall tv .uhro to imle.hon. aptp ro.ai or <br />rerR-icon ht the 0o %Iwfeter to ordered, the undefulmed agree, tit <br />wrtx t ant wtvk ftwnl it -fir tit txthpat of the ctarlwtxn of this permit <br />Signature (A Applicant <br />Water Well <br />CITY PERMIT N? 9152 <br />Date �9-�- 7 <br />❑ REPAIR <br />Mechanical Equipment <br />Fireplace/Wood Stove <br />Moving/Lifting Buildings <br />[and Alteration ( Excavation. <br />Grading. Filling, etc.) <br />Design Re%iew <br />Fire <br />Sprinkler System (Fire) <br />Other. <br />After -the -fact Investigation <br />❑ REMODEL <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 S <br />TOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee S� <br />This permit is not valid until the proper fee is pal 1 and it is approved <br />by an auftwized City Official. <br />Signature 9(fity Official <br />i <br />Codr Wtur--Fik Cop► <br />Canm-- tnspwor's Copv <br />Pink -- Ftnafxv Corn <br />Gold-- Applicant's Itmeo <br />