Laserfiche WebLink
GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />CITY PERMIT NO. " 6838 • <br />(03r (o.Date <br />Owner <br />Contractor <br />City License No. <br />(612)473-7351_,^ <br />iP(= <br />km-riUaS>^ <br />Sl3ii <naAddress <br />Address fijAPie <br />State License No__________________________________ <br />REMARKS AND SPECIAL CONDITIONS <br />/fTTAQ.f-4€rt\ <br />PERMIT TYPE AND FEE: <br />Inside Plumbing ( # Fixtures. <br />Water Meter (Size____) <br />Meter #__________ <br />NEW □ ADDITION <br />Fee S_______ <br />Fee $_______f <br />Remote # <br />Municipal Water Connection Fee $. <br />-opper <br />Municipal Sewer Connection <br />□ pVC DCast n. <br />Fee $. <br />MWCCSACCltarge Fee $. <br />□ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S^^/ilCL <br />Fee S_________ <br />Fee $_________ <br />Fee $-------------- <br />Fee $_________ <br />Other:. <br />Afte^the-ract Investigation <br />Fee S. <br />Fee $. <br />ACKNOWLEDGEMENT <br />T1i« uadtfiiiDcd hmby «diaowlid«Bs rvctipl of thli UmlUd <br />ptmill. Including acccpUnco of an ipocUl Infonnation, <br />lanna, condlliooa or raqulianatila wdttan above. The <br />undenUnda and affats under penally of law <br />that thia permit U ftrlcUy limilad In aeope to the worlc, <br />acIMly or fa»!«rovtmtnt 9ocUlad: that Ihla pctmli doea <br />not pant any authoHty to do week or acdvltlaa ra^ilfing <br />aaparala permit approvals; and that this peiroit done not <br />grant authodty to violaU any provision of any City <br />ovtMaance or SUta law, rule or regulallon. AH work AaD be <br />done In ttrtet compliance with all Clly ordinaneaa, building <br />codes and/or health department legulallona, and ahall be <br />aubjeet to inspection, approval lelecllon by the City. <br />Whenever so ordered, the undeaigned agrees to correct <br />any work found to be In vtoiauon of the condltioiis of <br />this permit. <br />Signature of Applicaot <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $.,St> <br />Fee <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />(a/\ <br />y <br />Code; Whlle-I Ue Copy Canary-Inspector'! Copy Plnk-i'inance Copy Gold-Appikani't Receipt