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GENERAL PERMIT
<br />CITY OF ORONO
<br />P.O. BOX tt
<br />CRYSTAI. HAY. MINNESOTA 55323
<br />(612) 473-7357
<br />Ow tx r � ""s- (,-444
<br />Contractor
<br />City license No.--_--a�L--_- ----
<br />REMARKS AND SPECIAI
<br />PERMIT TYPE AND FEE: I NEW
<br />Irtsitk Plumbing Infixtunti __--1 I -cc S
<br />Walter Meter ISve __. ) fee S
<br />hlctern .-- -- --- ----
<br />Remote it
<br />❑ ADI
<br />Municipal Water Connetwit Fee S
<br />I(I1Elplr ❑ - --
<br />Munici I Stwer Conrtatlaon
<br />PVC ❑ Ca -4 ❑
<br />MWCC SAC Charge
<br />On Site Sprtk S)stem
<br />ACKNOWLEDGEMENT
<br />Fee S
<br />Fee S -- - -
<br />Fee $
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<br />CITY PFRMIT N? 9021
<br />Date
<br />Wdre�rnlilJl / %
<br />4
<br />City
<br />)ITION ❑ REPAIR
<br />Water Well
<br />Mechanical Equipment
<br />Fireplace Wiood tilos c•
<br />Moving'Lifting Huddings
<br />land Alteration (Fxcasation.
<br />Grading. Filling. etc)
<br />Design Re%- w
<br />rife
<br />Sprinkk-r System (Fire)
<br />Other.
<br />Afar -the -fact Investigation
<br />IOTA I
<br />State Surcharge
<br />Total Nmouni Paid it, City
<br />❑ REMODEL
<br />Fee S —
<br />Fee S —
<br />Fee S —
<br />Fee S —
<br />Fee
<br />S
<br />Fee
<br />S
<br />Fee
<br />S
<br />Fee
<br />S —
<br />Fee
<br />S _—
<br />Fee
<br />S
<br />Fee s Z 1^y
<br />'l
<br />� s 0 /. C�
<br />4* 40 -7 3-�
<br />Ibis permit is mot .alld Intl the proper, Fee is paid and it is appnoved
<br />hs an authonnd Cm Official.
<br />%gnature A N t IIS Off- I
<br />1
<br />Pink IInowix('aff G.kl \ro-,anl, It,, v"
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