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GENERAL PERMIT CtTY PERMIT No 88'�9 <br /> CITY OF ORONO <br /> P.O. BOX 66 Date / ��—O � <br /> CRYSTAL BAY, MINNFSOTA 55323 <br /> (612)473-7357 <br /> Owner �� � � � P�I Address �� � � �� �� <br /> Contractor Address <br /> City License No. City <br /> REMARKS AND SPECIAL CONDITIONS <br /> PERMIT TYPE AND FEE: ❑ NEW � ADDITION ❑ REPAIR ❑ REMODEL <br /> Inside Plumbing(#fixtures 3 ) Fee $ 3� '�� Water Well Fee $ <br /> Water Meter(Size ) Fee $ Mechanical Equipment Fee $ <br /> Meter# Fireplace/Wood Stove Fee $ <br /> Remote# Moving/Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration(Excavation, <br /> ❑ Copper ❑ Grading, Filling, etc.) Fee $ <br /> Design Review Fee $ <br /> Municipal Sewer Connection Fee $ <br /> Fire Fee $ <br /> ❑ PVC ❑ Cast ❑ <br /> Sprinkler System (Fire) Fee $ <br /> MW CC SAC Charge Fee $ <br /> Other: Fee $ <br /> On Site Spetic System Fee $ <br /> After-the-fact Invesrigation Fee $ <br /> ACKNOW LEDGEMENT TOTAL <br /> State Surcharge: Fee $ � �� <br /> The undersigned hcreby acknowledges receipt of this Iimited permit, ���S� <br /> including acceptance of all special information, terms, conditions or Total Amount Paid to City F80 $ <br /> requiremenLs wri[ten above. Th2 undersigned understands and agrees � l�,��� <br /> under penalty of lati[hat this permit is stricdy limited in scope to the work, ��� <br /> activity or improvement specified; that this permit dcxs no[grant any <br /> authority to do work or activities requiring separate permit approvals:and <br /> that this permitdoes not grantauthority to violate any provision of any City <br /> ordinance or State law,ruie or regulation.All work shall be done in strict 'This permit is not valid until the proper fee is paid and it is approved <br /> compliance with all Ciry ordinances, building codes and/or health <br /> department regulations,and shall be subject[o inspection,approval or by an authorized City Offieial. <br /> rejection by the City.Whenever so ordered.[he undersigned agrees to <br /> cormct any work found to be in vialation of the conditions of this permit. <br /> Signature of Ap licant <br /> � �� Signature of�cial <br /> Code: White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />