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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 _-� C. �f?/ C <br />Contractor <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Plumbing Ofixtures _) <br />Water Meter (Sic _ ) <br />Meter # <br />Remote # _ <br />Municipal Water Connection <br />❑ Copper ❑ <br />Munici Sewer Connection <br />PVC ❑ (;I"t ❑ — <br />MWCC SACCharge <br />On Site Spetic System <br />A('K NOW LI:.IX; F.MEN'T <br />NEW <br />Fee S <br />Fee S <br />Fee S <br />❑ ADC <br />Fee S <br />Fee S -- <br />Fee S <br />tie• un lef,t'rt•d hereht a e, rtLnrx .4 Ihr. luniled Irrrnn <br />ntitthnr: aucl4artr .4 all • mfrarttatt„n. term,, wrtlrlr.m. .r <br />rryuucmrnt wnncn ah,u• 1he urtkrvFrtYl undcr%mnd% aril mist- <br />urtlerrtnalh.dI:ntthmthnrt•rmoti, Irk ilthnutr•dinvnrtit, therank. <br />acutnt nr tmpnacrrt•nt .tttrfrrtl. that tht. Mmn d.r� n.4 print ant <br />authrmtt i,do wotk or acl.vuc• n•ttutrtrW vpartt• rt•rmn apprti%ak. and <br />that the. p rmn dn� not seam authon:� to %it+jW am pro%won .4 am ( tt t <br />tntfinarke tit State Litt rule in repula . rr All N.nk .hill N- dori• in girt t <br />umrplunLe wth all ( it% .Kdmart.� hmldmE Little, and ur health <br />dep•ntntnl iepuLru.mh and hall tt• nhKvl to mIx-,tum. appimal or <br />rctnu.et ht the (•11% Nli•r)t•tcr w, onlered. the urtrrraFned agrct, to <br />wrn•.t .tit, task (.turtl lode tit iu4auon.4 tht-wrilmon..4 thn rt•rm,t <br />Signature of jW;1 nt <br />CITY PERMIT N? 9020 <br />Address S ! L) ✓Py <br />Address <br />City <br />IITION ❑ REPAIR <br />Water Well <br />Mechanical E4uipment <br />FireplaLe/ Wcxxd 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 />State Surcharge: <br />Total Amount NO to City <br />❑ REMODEL <br />Fee S _ <br />Fee S — <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 j <br />FecS_J - , <br />This permit is not valid until the proper fee is paid and it is approved <br />by an authorised City Ofieral. <br />Signature �gVCit} Official ' <br />/I ► r 1 6c)( J z-( <br />Ciwk: White 1 tic (•t,pt ( .mart Imrr .'It,r " („ra Pink Finark-c Cups. (Mild \ppltant', ltetopl <br />