|
; _
<br /> ,._. ..__. _..._.__..._. .._...:._�..�..
<br /> ,;:�� ---_.-_
<br /> �+ ;� �
<br /> , / r —� ,f
<br /> GENERAL PERMIT cITYPI:RMITNO. ._ �'13� � w,
<br /> � CITY OF ORONO '�
<br /> ` �-� -�� ' .
<br /> �' , N.U.BOX 66 Uatr__ "�'
<br /> ��.:
<br /> �u'„ ' CRYSTAL BAY,M1i1NNESOTA 553?3 r'
<br /> �"' � (6'`)473-7357 �
<br /> Own�r ��N �L..Z A�l�frc,,._ �C."� �C� �
<br /> A�r/�c w ��---
<br /> Contra�tor L�1 Tm�� h'K2C� S Ad�lress �N�2./N G �' 1�
<br /> ' City Licens� No. Statc Liccnsr No.
<br /> I '
<br /> j RE:MARKS ANU S!'I:CIAL CONUITIONS
<br /> j _ Il do � �. '' �;�� ��e�.� �� G " s�,�o ��fl� ��.,� '
<br /> ;
<br /> -+ PE:RMIT TYPE: AND FEE: �{NEW ❑ ADDITION ❑ RF.I'AIR � .
<br /> ! !`�
<br /> ' � Insid� Plumbing( � fixtures ) Fee $ �' ; '
<br /> Un Site Septic Sys[cni Frr S �� '
<br /> � r ,
<br /> Wate:Meter(Size ) Fee $
<br /> Watcr Well F« 5 '
<br /> h:etCr # — � ,�
<br /> Rei,iote# Mrchanical Equipmrnt Fc;e S _
<br /> �� Municipal W�ter Connection Fee S Moving/Lifting Buildings F�C -
<br /> S �-.
<br /> ��r ❑Copper Ll _
<br /> Land Alteration (Exc;�vation, F« S ,
<br /> Municipsl Sew�r Conncction Lrading, Filling,ctc.)
<br /> Fee $
<br /> . � ❑ PVC ❑Cast ❑
<br /> Othcr: Fee S
<br /> ��.� !1d'rVCC SAC Charge Fee ;
<br /> Atter-tltc;-fac[ (nvrsti�;ation FCt S
<br /> �
<br /> " ! —
<br /> f � AC'KNOWLEDGEMENT
<br /> ,:' � "i'OTAL
<br /> The widersiened hueDy rcknowladge�tecND�ot thl�fimited
<br /> Dennit, u�cludmr receVWce ot r!1 �peclal In/ortn�llun,
<br /> lermc, c•unditlonx or �e�ulremen4 wntqn �bov�. Thu
<br /> j uiidrrw�{»ed undrnWnd� :u�d r�r�e� u.idar prnrltY u( lrw ����1' SUfI'�l:ll�'C' �'�l � �
<br /> � thr[ thu Yrrtnll L nAcUY Urnllad ln r^op� tu th• wurk, -
<br /> acU�lty or trn�rov�mant �Dsclfled; th�t thu Dermlt dcxs Sr�
<br /> nu� �rrnt unv ruU�unq to du work or �«v�Uu nVu�rin[ TOI:1� F�IIIUUIII ��dl�� lU��IIy �'l'l' S ��
<br /> �.flu•lr pemilt rpDruv�l�; u�d lh�l thb p.•enit don nut -
<br /> �. rruu ruU�urllY W vlul.le .nY DruNNon of ,u�Y CItY
<br /> ordanancr or 5tata Iaw,rult or re�ulaUon. All work�hall ba
<br /> � dor.e In xtdct cwnVLrnt� wlth �!1 CItY urdlnrt�cr�, bulldln�
<br /> b cude� �nd/ur herl{1i dsD�rtm�nt r��ul�4un�, rno �h�ll b� 1f11S J)l'fllll� 11 IIU� Vil�ll� Ull�l� ��lt' proprr irc IY 4)JII� :i�;�.
<br /> ` i wbl�ct Gu WD�cdbn. rDDrovrl ��r nl�cdun by th� L'Itr.
<br /> Wh�never �o �,�Jered, U�e und�nlQn�d a���s to :orract it iti a����re�vcd by sn authurizr� City Oft7cial.
<br /> . � �nY wc�rk fucnd W 1� 1n v�olrtlun ul th� cundltlorn uf
<br /> . thb De[mlt.
<br /> Sign:�tu of Applicwnt / Siguatur 'ity Ot�liri�
<br /> �� % ?"7_,�: � ��� .
<br /> ('udc.White--I lle CupY C�n:uY-Inrpcctur's CupY Pink I inanee('opy Gold Applicant't Roeupl
<br /> 4 yy�E
<br /> , �'r .: a'Y ' �
<br /> 7�� a�, j `¢`x � � �lY��h Ti �. �:r�r � 4�h(,�'��yL�'� � 1
<br /> � � �!�� �� � ^.
<br /> ,�pS` �.'`�. � .��.i � ,�i'`tf' �� s�'�r ��F YS��' -�L;7����ffirie f��a�Art `�k��r�,nrt � r., R�_ 5b r�� F�t 7 ., i.:
<br /> t��u b.a�,. k � d� i, 4;¢� �4,a•�'�"',� �r� '4f J�� �,�i i�s�x �`s.� ry . � ,;:� ,€ ��'
<br /> '�`g���r#�4���� :1"�+.��++'����� k�'�r,,��'�rk,��r�3��kD a� e„�iT;�+,��� . r'; m � � s
<br /> ��, 1 ti.w k 5,��` °' �x � F-q 5 w� x/. �i�" n:. IRtit,,,�� � ,
<br /> h�:" � ���i� �, :�;'� �r''' Aa(, Ftzv - ��'� ,., y'�:( �.� L, 6,,� �.r u,.� � . t..: r _.,�� ; �s�ve�ti�'^�
<br /> y �� 2� i �'�� e �k "���t '�' t,�' 9c, ,� �5y`�7 'Ye�,� 4 .v �'��, yy�t �"� �'t te�� �� � '�ef't ��
<br /> s
<br /> ���:. ,�; ,°i'� �����r ak�`^� i� �� � � �.`x�aa�t'.,,:`a�'�!ti s �� -i;� wt"� r ��,^� a�«.G mx �;'a�",n�'tiruW�2� + , %�� '� ��ii5` } .�. . .
<br /> �. �i��`�':.����? �.4 � � M��et ,.�.:°� f %�;r..�„Y. �. ,n'4���Y�i, ���t�, L..'.
<br />
|