Laserfiche WebLink
CITY PERMIT NO.—'71,`�g <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 Date _ <br />CRYSTAL BAY, MINNESOTA 55323 <br />161 _1473-7357 <br />Owner �• �Address �d-�_ ' <br />Contractor l/ ^ 6I)S. Address <br />4 <br />City License No <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE ` D FEE <br />Inside Plumbing ( # fixtures <br />Water Meter (Size ) <br />Meter # _ <br />Remote # <br />NEW ❑ ADDITION <br />)\ Fee S <br />Fee S <br />Municipal Water Connection Fee $ <br />❑ Copper <br />Municipal Sewer Connection Fee $ <br />❑ PVC ❑ Cast ❑ <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee $ <br />The undersigned hereby ackno%ciedges receipt of this limited <br />permit, including acceptance of all special Information, <br />terms, conditions or requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity or improvement specified: that this permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals: and that this permit apes not <br />grant authority to %iolate any provision of any City <br />ordinance or State law, rule or regulation. All work shsll be <br />done In strict compliance with all City ordinances, building <br />rudes and/or health department regulations, and shall be <br />subject to inspection, approval or rejection by the City. <br />s Whenever o ordered. the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signature f Applicant <br />State License No. <br />❑ RUPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Other: <br />After-ttie-fact Investigation <br />TOI.`.L <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee <br />$ <br />Fee <br />$ <br />Fc' , <br />$ <br />Fee <br />$ <br />Fee <br />$ _ <br />Fee <br />S _ <br />Fee $ <br />Fee $ sell JLl <br />This permit is not valid until the proper tee is paid and <br />it is approved by an authorized City Official. <br />Sig t e of City Official <br />.Z/bS s <br />Cale- White. -File ('nnv Canary-Insnector's Coov Pink - finance Copy Gold Applicant's Receipt <br />