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OvsTicr <br />Contractor <br />City License No. <br />GENERAL PERMIT <br />CITY OF ORONO <br />RO. BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />^ (612)473-7357 <br />/ j (em a n Pi m h •/- h! /% <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT N9 <br />II h <br />8774 <br />Date <br />Address <br />Address <br />Citv _ <br />f) bin.\c/a^ <br />jy\C{iOle <br />PERMIT TYPE AND FEE <br />Inside Plumbing (^fixtures ^3) <br />Water Meter (Size___) <br />Meter//_____________ <br />NEW <br />Fee S <br />Fee S <br />□ ADDITION □ REPAIR <br />Remote # <br />Munidpal Water Connection <br />□ Copper □ ____ <br />Munidpal Sewer Connection <br />□ PVC □ Cast □ <br />MWee SAC Charge <br />On Site Spctic System <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />□ REMODEL <br />Water Well Fee S <br />Mechanical Equipment Fee S <br />Fireplace/Wood Stove Fee S <br />Moving/Lifting Buildings Fee $ <br />Land Alteration (E.\cavation, <br />Grading, Filling, etc.) <br />Design Review <br />Fee S <br />Fee S <br />Firp F pp S <br />Sprinkler System (Fire)Fee S <br />Dthor Fpf* S <br />After-the-fact Investigation Fee S <br />ACKNOWLEDGEMENT <br />The undeRipned hca*b\ ackmmledger receipt of ihi^ limited permit, <br />irKludinp aaTpUina* of all ^plx^al infornution, terms, conditions or <br />renuircmcnts written abovv. The undersigiH'd uixlersiands and agrees <br />under fxrnaltyof law that ihis permit isMricily limited in »co|x* to the work, <br />activity or improvenK*nt sfccified; that this permit d(vs not grant an\ <br />authority to do work or activities requiring vparale permit approvals; and <br />that thlspemiit dtx:s not grant authority to viohteany provision of any City <br />ordinance or Stale bw. rule or rrgubuon. All work shall be done in strict <br />comptbnee with all City ordinarKcs. building axles and/or health <br />department regubuonv. and shall be subject to inspectio.i. apprmal or <br />rejanion by the City. Whenever so ordered, the undersigned agrtvs to <br />airaxt any work found to be in viobtion r^f the amditions of this permit <br />TOTAL <br />State Surcharge: <br />Touil Amount Riid to City <br />Rc S <br />This permit is not valid until the proper fee is paid and it is approved <br />by an authorized City Oflicial. <br />Signature of Applicant <br />! 0 <br />Signature of City Oflicial / <br />Code: White- f'ile Copy Canary™ Inspaior*s Copy Pink—Finance Copy Gold —Applicanfs Receipt