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GENERAL PERMIT <br />CITY OF ORONO <br />10. Box 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612) 473-7357 <br />Owner <br />Contractor ( ✓ / ✓!�- E'er <br />City License No.11 <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT N? 9120 <br />Date tP-7 <br />Address L�(.� 0 62 ld u t' to 2 <br />Q* <br />Address <br />City <br />PERMIT TYPE AND FEE: D NEW 0 ADDITION 0 REPAIR 0 REMODEL <br />Inside Plumbing (NGxtures ) <br />Water Meter (Size ) <br />Meter H <br />Remote b <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S <br />O Copper 0 <br />Municipal Sewer Connection <br />xPVC O Cast O <br />MWCC SAC Charge <br />On Site Spetic System <br />ACKNOWLEDGEMENT <br />Fee S>3y)•OV <br />Fee S <br />Fee S <br />'nM untimignd beaky ackrrrukdgss utdrot of this limited permit. <br />irw1oding amcptarac trf all six1131 information, tants, amditiom tit <br />rrqulrrments w6nen above. The undenigncd underwnds and agrees <br />under prnahy of lass ttut this permit is %trial y limited in sasR to the "wk. <br />actisity tN imprrnrment specirral: that this permit drt+ not grant any <br />authority todouotkoraetisiticsrrgWdngselumtc lrrmitapprosaleand <br />that this permit da-. not grant authority to siob tc any prosi%ion (fany City <br />onlirurme or Statc law. rulcor rcrib, on. All uork shall be d.+ne in strict <br />omtplurrce with all City onlinarts. bttilding esxim aml/or health <br />depanment reguladom and slull be subject to impection. approsal or <br />rejcohm by the City. Whencsrr At otdend. the undersigned agrscs to <br />cortat any work fount to be in %ioUtion tithe amdidom tdthi, permit. <br />Si ate of Appli nI <br />2Z I Z . <br />Water Well <br />Mechanical Equipment <br />Fireplace/Wood Stove <br />Moving/Lifting Buildings <br />land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Design Review <br />Fire <br />Sprinkler System (Fire) <br />Other. <br />After -the -fact Investigation <br />TOTAL <br />State Surcharge. <br />Total Amount Paid to City <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S 5-07 <br />Fee S — <br />This permit is not valid until the proper fee is paid and it is approved <br />by an authorized City Official. <br />Sijna u • of City Official <br />• �D` <br />Cote: Whhe—talc Copy Canary—Impectors Copy fink—Finatim Copy cow --Appliances Receipt <br />