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GENERAL PERMIT <br />CITY OF ORONO <br />CRYSTAL BAY. %IINNi:SOTA 55323 <br />(61 2) 473.7357 <br />CITY PERMIT NO. L 7558 , <br />Dail. _ jq - 9 - 84-{ <br />OwnerAddms 12 Q- $T l a r <br />Contractor - Q � 044 S4bJn t s W EAA— [Q Address _ JWU "n _ <br />City License No. PEN Di N_[� State Llcenx No.. Z --7Z7 <br />REMARKS AND SPECIAL CONDITIONS <br />Ilet RNIB TYPF• AND FGF ❑ NFW <br />Inside Plumbing 1 f ti mx_ 1 <br />Water Mcler (Size_i <br />sileter M <br />Remote# <br />Municipal Nater C'omle:tlnn <br />❑Copp,'r E1 ------ <br />Municipal Sewer Connc:then <br />❑ PVC ❑ ('est ❑ <br />MWCC SAC Charge <br />ACKNOWLEDGENIFN7 <br />❑ ADDITION <br />Fee Ste,_ I <br />Fee S <br />I cc S <br />FCC S <br />Fee <br />Ties undsrdpesd hsnb) stied—l.dps meript or this hmll.d <br />Psfmlt. In4eidmtt ''"'Isms ur sU 0-fal Intormed„n. <br />urns, .antLn,Ye- nee t.ttmnmenbe wnt!een sbrns. The <br />utsd.ween.d uod.r.4nd. -1 sp... und.r Iwnslts ut Ise <br />Mu the- P.emit e- .uktA IJn,iwd to rows to th. .W%. <br />.,elllts ,u Pr+Pren—.1 .P• 41.d. th.1 the. twnnil due, <br />nut pant seer .nth.,nn t„ du r.Ys 4-1 srtr\Itks requiring <br />..Paste twrmet .PPI—iJ, .red th.+ Nr• Permit drrs nut <br />pate suth,mt, v, \,.d.t, N\ I.r.n+Y r.n eel int t'lls <br />urdlnm. - "491 Ile' rul• .. rlsut.u..n %V ...Ys shall bw <br />dune In suxt rom PtJsn,• .nA ill l u, „rdwrsn..s, t eldlnte <br />.rxls snit..r besith drPatm.nt rep.tspun.. .nit MsY a <br />• .ubwet t., ieetP•, u..'. .PPI., -.J .V nk,P.,n be m• ('sits <br />r h•nr,er ..rdrrrd, in, se-w—sn.d .sr — In rum,t <br />sn, ..us !.sand r., ell, +n .-L..- 1 tie r„mm,..n, ..l <br />the. W r^+tt <br />Sign urc of Applicant <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving' Lifting Buildings <br />Land Alteration (Fxcavation. <br />Grading, Filling, Cie.) <br />other - <br />After -the -tact Investigation <br />TOTAL <br />Fee S <br />Fee S —440, p0 <br />Fee S <br />FCC S <br />Fee S <br />Fee S <br />Fee S <br />State Surcharge. Fee S . 5D <br />30 � yo <br />Total Amount Paid to Cit) Fee S <br />This permit is not tand until the proper ke is paid and <br />it is appeosed h% An authorized City Official. <br />('Ip <br />Code White 1 de ( ur) Cmun tnq+and'a Copy Pink 1 inanar Cop) (kdd AppWiLm'. R"pt <br />