Laserfiche WebLink
GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO. <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />Date. <br />6656 <br />Owner.tharles dff/as <br />Contractor. <br />City License No.. <br />.Sladold <br />Address. <br />Address. <br />''Ar/c <br />/Vjhnp/7)ntrx ^_______ <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Plumbing ( # fixtures. <br />Water Meter (Size____) <br />□ NEW □ ADDITION <br />_) Fee S________ <br />Fee S________ <br />Meter #. <br />Remote # <br />Municipal Water Connection <br />D Copper n---- <br />Fee S_ <br />Municipal Sewer Connection <br />□ PVC □ Cast Q. <br />Fee S. <br />MWCC SAC Charge Fee S. <br />□ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Fee S. <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S. <br />Fee $ <br />Fee S <br />Fee S <br />A/f).no <br />Other:. <br />After-the-fact Investigation <br />Fee S. <br />Fee S, <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges receipt of this limited <br />permit* Including acceptance of all special information* <br />terms, conditions or requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is sirlcdy limited in scope to the work, <br />acUvity or improvement specified; that this permit docs <br />not grant any authority to do work or activities requiring <br />separate permit approvals; and that this permit docs not <br />grant authority to violate any provision of any City <br />ordinance or SUtc law, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subject to inspection, approval or rejection 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 />Signature of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S. <br />Fee s: <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sigimture of City Official <br />Code: Whitc-HIe Copy Canary-Inspector’s Copy Pink-l‘inancc Copy Gold-Applicant’s Receipt