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GENERA <br />L PERMIT CITY Pt: RMIT NO. 8439, <br />CITY OF ORONO „ate G� <br />CRYSTAL BAY, MINNIiSOTA 553:3 <br />t612) 473-7357 T <br />l U <br />J . Address <br />Address <br />untractor <br />State License No. <br />'ity License No• <br />RL' MARKS AND SPECIAL CONDITIONS <br />Pt.-R&IIT TYPE AND VLF: ❑ NI:W ❑ ADDITION ❑ RI- .1'AlK <br />Inside <br />Fee S Water Well <br />PlumhinglMfirtuRsll <br />Fte S _ - _ Mechanical Equipment <br />Water Meter (Sire _t <br />Sletcr# \toning Litling Buildings <br />Kepone <br />Land Alteration (Excavation. <br />Municipal Water Cuntion <br />Fre S _ - — -- Grading. Filling, etc.) <br />❑c,per <br />;(Municipal Sewcf connection Fee S <br />❑ I'V( ❑ Cast ❑� I ) <br />MWCCSACCharge <br />Fee S_`�!�'� <br />On Site Septic S) aem Fee ',_� <br />ACKNOWLEDGEMENT <br />7•11• uuderwgn.d h.raby wknuw1.111•1 receipt ..t this Um Red <br />ecjsj <br />yetmlt. crndtUons fit Vquimmruts rnllen abune.ation. The <br />terms. <br />undenagned undpennitrnLnM anJ signers undo prnalN of U. <br />pe <br />this <br />t 4,w unprwrnienll wecifled. tth. is uthis psrmlt does <br />nen grant sins authunts to do work or KU iU@s lequinng <br />not <br />lepw.te penult apOr-alai, ns�siprovisiot Ws n t of apult ps City <br />grant authority to <br />ordinsince ur stale law. rule sir regutation Ali work 1hall be <br />done in Witt ctd11Pliarire with as City onitnaicei. building <br />codes andlnr h@.,M dsiVartm.at regulations, and 611011 b4, <br />wt•lecl to Utspeetim. aODrord u< nNc Uon by Uie Coy. <br />to correct <br />w'henrler w oni jed. Liss undenignsd &9"" <br />4,111wn k found to by in lonlauon of the cu -bit" l of <br />this pennit. <br />Signet tr o1 Applicant <br />✓ t <br />Can,o Inw"tor'sCop) <br />C'odc w'hitc 1 dot .gyp) <br />Fee S <br />Fee S _ — <br />Fee S <br />Fee S <br />ire <br />Fee S <br />prinkler System (FireI Fee 5 <br />)ther. Fee S <br />ifter-the-tact Investigation Fee S <br />TOTAL <br />State Surcharge: Fee S�-- <br />Total Amount Paid to City Fee <br />This Pennit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of City Official <br />pint - t Inaits Copy Gold - Applicant's Receipt <br />