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GENERAL PERMIT CITY PERwr N? 9033 <br /> CITY OF ORONO <br /> P.O.BOX 66 Date <br /> CRYSTAL BAY,MINNESOTA 55323 <br /> (612)473-7357 CI <br /> �/ � ) /,, <br /> Owner �1 -- 7�T Address S- /`-'®-,She:)re, <br /> bi- <br /> Contractor G Address& V k C��' " I? <br /> City License No. City qOldne-n 1266 1 <br /> REMARKS AND SPECIAL CONDITIONS Q <br /> ZAArfoLtC1, 9�nDa <br /> i <br /> PERMIT TYPE AND FEE <br /> VNEW ❑ ADDITION ❑ REPAIR ❑ REMODEL <br /> Inside Plumbing(#fixtures ) Fee $ Water Well Fee $ <br /> i <br /> Water Meter(Size ) Fee $ Mechanical Equipment Fee. $ o 0 <br /> Meter# Fireplace/Wood Stove Fee $ <br /> Remote# <br /> Moving/Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration(Excavation, <br /> ❑ Copper ❑ Grading,Filling,etc.) Fee $ <br /> I <br /> Municipal Sewer Connection Fee $ Design Review Fee $ <br /> Fire Fee $ <br /> ❑ PVC ❑ Cast ❑ <br /> Sprinkler System(Fire) Fee $ <br /> MWCC SAC Charge Fee $ Other.�1� �,.Q,� Fee $ <br /> On Site Spetic System Fee $ <br /> After-the-fact Investigation Fee $ 7' <br /> ACKNOWLEDGEMENT TOTAL, <br /> State Surcharge: Fee $ t O <br /> The undersigned hereby acknowledges receipt of this limited permit, d <br /> including acceptance of all special information, terms, conditions or Total Amount Paid to City Fee $ <br /> requirements written above. The undersigned understands and agrees <br /> under penalty of law that this permit is strictly limited in scope to the work, <br /> activity or improvement specified:that this permit does not grant any <br /> authority to do work or activities requiring separate permit approvals,and (® <br /> that this permit does not grant authority to violate any provision of any City <br /> ordinance or State law,rule or regulation.All work shall be done in strict This permit is not valid until the proper fee is paid and it is approved <br /> compliance with all City ordinances, building codes and/or health b an authorized Ci Official. <br /> department regulations,and shall be subject to inspection,approval or y City <br /> rejection by the City.Whenever so ordered,the undersigned agrees to <br /> correct any work found to be in violation of the conditions of this permit. <br /> Signature of Applicant <br /> - Signature of City Official <br /> 41 2 a6 <br /> Coder White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />