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GENER�L PERMIT CITYPERMITNO. ���9 <br /> CITY OF ORONO <br /> r.O.EOX 66 Date � �'�� <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612)473-7357 � <br /> Owner ./'� � �—'"�[5����';1 ° I��- �� Address � l`\-� �% �/"C'��,�_�; �7'L.�� <br /> Contractor � �� /� • li���� �C'��2��/'�(� Address ��� �`E'C-'�L.�li/��o( K5' / �. (� <br /> City License No. � �_��/ �C State License No. <br /> / <br /> REMARKS AND SPECIAL CONDITIONS <br /> _�� �-G-���� ��4�,r`� ir�ri� .c�t-.�'� <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION �BEPAIR <br /> Inside Plumbing (#fixtures_) Fee $ Water Well Fee $ <br /> Water Meter (Size) Fee $ Mechanical Equipment Fee $ �fl� <br /> Meter# <br /> Remote;� Moving �Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $ <br /> � Grading, Filling, etc.) <br /> ❑Copper <br /> Municipal Sewer Connection Fee $ — _ <br /> Fire Fee $ <br /> ❑ PVC ❑Cast n Sprinkler System (Fire) Fee $ <br /> MWCC SAC Charge Fee $ Other: Fee $ <br /> On Site Septic System Fee $ After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> The undersigned hereby acknowledges receipt of this limited <br /> pexmit, including acceptance of all special information, <br /> terms, conditions or requirements written above. The � t—�� <br /> undersigned understands and a�ees under penalty of law State Surcharge: Fee $�,j�_ <br /> that this permit is strictly limited in scope to the work, <br /> activity or unprovement specified; that this permit does --� �l <br /> not grant any authority to do work or activities requiring Total Amount Paid to City Fee $ �� � �V <br /> sepazate permit approvals; and that this permit does not <br /> grant authority to violate any provision of any City <br /> ordinance or State law,rule or regulation. All work shall be <br /> done in strict compliance with all City ordinances, building <br /> �oaes and/or he�cn department regulations, and sneu be This permit is not valid until the proper fee is paid and <br /> subiect to inspection, approval or reiection by the City. lt 1S 7 roved b an authorized Cit Official. <br /> Whenever so ordered, the undersigned agrees to correct pp Y Y <br /> any work found to be in violation of the conditions of <br /> this permit. <br /> Signa�k�rre�f� lican Signa ure of City fficial <br /> ''�— � C'�,�`� <br /> Code:White—Pile Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanYs Receipt <br />