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t ►►, Irl k\tl I ' � , -- 1 <br />GENERAL PERMIT 0721 <br />CITY OF ORONO <br />P.0.11t I\ oo <br />CR) STAL BAY. %II\NESOTA 55323 <br />1612)473-7357 <br />owner <br />Contractor ; i' . , _ _{1� Addre%s <br />City License No. State Llcenx No. <br />Rl NARKS AND SPECIAL CONDITIONS <br />1'1 RN17 Tl Pf :\\D F1 1 ❑ NFW ❑ ADDITION <br />Imide Plunlbilig 1 s t1%turc%_) Fee S <br />Water Meter 1 Site—) Fee S <br />Meter t+ — <br />Remote 4 <br />Nuulk.tpal Nater Connection Fee S <br />❑Copper Q -- <br />Municipal Sewer C'omwt:uon Fee S <br />❑ Pvc ❑ l'j,1 n _--- <br />M:YCC SAC Clwige Fee S <br />ACKNOWLEDGL•N1:NT <br />Thr unJ•rYnnrJ hrrrbt atk... MJg.• nr jpw„uthis limited <br />p•nwrt. 1-1.4-1 .rrlplI—t <br />of rV .Pe• <br />t.mt.. ...ndltirm. rN nquifefn.rtti .return b-1, Tt. <br />uhderuyr.l undenwada and eae.e under P ­411 .f Ira. <br />that this penrllt 1s etiitlll ttratwd to w"W to th. ...k. <br />ec Utttr or Unpm"ment w"Ified: that this hetmu 4.w. <br />n-.tgrant W. eutnr.itl to dre .ark nr ee ti•tw. repulrtng <br />rvu.tr Permit gpprotal.. and Wat Wu prrrnrt do.. nut <br />Went .0 h.r/lr to alae, Wf p.u.tiun ul an, CIIV <br />oedirt.nr. or %taw la.. rule - regulation. all .ark ahem be <br />lone In .taft eumphenr. .ith ea Cit* urdtnutt... buddtn$ <br />eud.s sndlor health drpettla..t n{ulatiuro. Wd .heh a <br />eubwt to In.pet U,.n. Wprmal up rei.rtiun br th Call. <br />,h h.nr.•r .0 ordrn4. N• undersigned .gn.. to run.tt <br />enc .,,rk 1, nd 1„ is, an ttol.u.m .,f the ,..ndtu ,n, ..1 <br />thla prmut. <br />ature 01plican y <br />i ZiZ ✓ /11y <br />l'utk Massie 1 ik Cury <br />Ujrw> trisr"'W-I Cup* <br />❑, <br />Rl PAIR <br />On Site Septic Systenl <br />Fee <br />S -- <br />S <br />Water well •- <br />Fee <br />Mechanical Equipment <br />Fee <br />S <br />mosing/Lifting Building. <br />Fee <br />S <br />Land Alteration IFxcatauuil. <br />Fee <br />S <br />Grading. Filling, etc.) <br />Other <br />Fee <br />S <br />After-the•la.t Imestigition <br />Fee <br />S_ <br />Iul-AL <br />SWte sumbirge: <br />Total Anwunt Paid to City <br />!;7� <br />Fee <br />Fee Ste= <br />This pennit is not valid until the proper tee is paid and <br />it is approved by an authorized City Official. <br />Signature of <br />Pini 1 iftgece ('taps t;uw Ap w"I'. Remipt <br />