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<br /> �'' '+���` ��NEFAL PERMIT CITYPERMITNO. 81�2 �
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<br /> �`���'�� � CITY OF ORONO
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<br /> 3rA�'t. P.O.BO� 66 pa<<_ — � � —�j.
<br /> ,`����� �' CRYSTAL BA`c',h1INhESUTA i5323
<br /> �`�.=-� ,'� (612)473-7357
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<br /> {�re __-1-
<br /> 'm= �'� Owner_ �J �1'��C``fl ' c� I,�
<br /> �� ��M f-�S Address_�.�� 1 , ��v'1�'_` \ ��1''f_'e �
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<br /> � � � �� Contractor �-L r' '
<br /> f � C�F'1 l� Address P �� ��C�X ;�� �
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<br /> City Licrnsc No. , �
<br /> Statc Licensc No. G� 1 I !� h� ��
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<br /> R�hfAR�S AhD SPECIAL COI�'DITIONS �5����
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<br /> � PLRMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑REPAIR
<br /> �, 3^�"�,:�.� _ -
<br /> �ti
<br /> + �, � Inside Plumbing(�f�ix[ures�) Fee S �.�`�-�.�
<br /> -;��t• -----_ Water�Vrll Fee S
<br /> ' Water�feter(Si•r.e_) Fee S _ tiferhanical Equipment
<br /> Meter� — Fee S �
<br /> Remot�!� Aloving/Lifting Buildings Fee $ `
<br /> �tunicipal �';�ter Connrction Land Alteration (Fecavafion,
<br /> Fee S___ Fee S
<br /> n•,��..
<br /> ❑Co{,�er ❑ Grading. Fillint; �
<br /> �, .�'� Municipal S��ver Conncction Fire
<br /> Fee S Fee 5
<br /> ���+�y .
<br /> t�; � P��C ❑Cast �_ Sprinkler System (Fire)
<br /> Fee S
<br /> MWCC SAC Charge Fee S__ ` '
<br /> -- Other: �Cv �� -�(�� Fee 5 ����
<br /> On Site Septic System Fe: S
<br /> After-the-fact Invr;tigation Fee 51=��
<br /> ACKNOWL�DGEMENT TOTAL
<br /> Th.undenl�ned her�by rcknowled[es receiDe of thfe llmlted
<br /> permit. inc�udinr acceDtanee of all special (ntormatlon,
<br /> term., condldons or teQu[nments wdtten ebove, Thc
<br /> undersi�ned undentands and aaeea under Denalty o( law State Surchar�e: . ��
<br /> a �
<br /> th�[ thb Dermlt f: ftr{��y umlted In xoD� to the Wo�k. Fee
<br /> acdvitv oz Improvement specltted: Chat thls permlt doee
<br /> n�t Vunt any suthoT(ty to do work or�ctivttfe� reQutr{n� T /�
<br /> KD�rot. permlt ayprov�]i; and that th(s � ' 1 Amount Paid to City Fee S � `)
<br /> tr�nt rutho�lty to �jol�te � �eR�It dop not
<br /> Y Drovlflon o! any Clty
<br /> ordinance or State i�w,ru)e or reQulatlon.Ap work ahall be
<br /> done In strlct enmDllance wtth all Cft3• ordlnancet,buUdinQ
<br /> code• rnd/or health devartment re�vlauona, and �h�11 be T)11S OCI71112 is not valid until the proper fee is paid and
<br /> wb)ect to fnsyteUon, ayproval or rc)ectlon by the Cley,
<br /> Whm�ver io ordend, the undenf�ned �trr,�� to cortect it is a��proved by an authorized City Official.
<br /> any wnrk found to be In v�o1��,�� o� We eondldoni of
<br /> u,t.v•m,�t, �
<br /> Signaturc of Applicant Si�;naturc of City Ofticial
<br /> ��1.� �i��
<br /> � �` ��L��
<br /> l�', Cadi:Nhi�c—!i1c Cu�y ('anary-�lncprc�or's CupY Pink 1 inance Co �
<br /> PY Gold—Apr�irant's Receipt
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