Laserfiche WebLink
GENERAL PERMIT CITY PERMIT NO. 8565 <br />CITY OF ORONO <br />P.O.BOX 66 Date _ <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner i� <br />C C k ✓ t t;�l JL- Address 30919 a r d ► ecJ Ln <br />ContraL . i PAC, G 1 Address <br />City License No. I U - T <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (01f xiures_) <br />Water Meter (Size_) <br />MeterN <br />Remote ';+ <br />State License No. <br />NEW ❑ ADDITION ❑ REPAIR <br />Fee <br />Fee <br />Municipal Water Connection Fee <br />❑Copper n <br />Municipal Svwer Connection Fee <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee <br />On Site Septic System Fee <br />ACKNOWLEDGEMENT <br />e — (Water <br />Well <br />Fee <br />S 30. <br />( <br />S _ _—__ iMechanical <br />Equipment <br />Fee <br />S <br />Moving /Lifting Buildings <br />Fee <br />S <br />S <br />Land Alt ration (Excavation, <br />Fee <br />S <br />Grading. Filling, etc.) <br />Fire <br />Fee <br />S <br />S _ <br />Sprinkler System (Fire) <br />Fee <br />S <br />they: <br />Fee <br />S <br />S <br />After -the -fact Investigation <br />Fee <br />S <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of ell special information• <br />teems. conditions or requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work. <br />activity or improvement specified. that this permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals: and that this permit does not <br />grant authority to violate any provislon of any City <br />ordinance or Slate law, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regOitions, and @hall be <br />sub)eet to inspection, approval or refection by the City. <br />Whenever so ordered• the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signatur. -)f Applicants <br />TOTAL <br />State Surcharge: <br />Fee S <br />Total Amount Paid to City Fee Sa�d•S J <br />This permit is not valid until the proper f. d and <br />it is approved by an authorized City Official. <br />Signature of City Official <br />Code white I de Cup- Canary inspector's Copy Pink -Finance Copy Gold -Applicant's Receipt <br />