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GENERAL PERMIT CITY PERMIT NO. 7777 , <br /> CITY OF ORONO Date <br /> P.O.BOX 66 <br /> CRYSTAL BAY,MINNESOTA 55323 <br /> (612)473-7357 <br /> Owner PlaEc k G klol f Address-1020 ,Q V e 4,uA <br /> Contractor s-t�v� Address / -IN <br /> City License No. State License No. <br /> REMARKS AND SPECIAL CONDITIONS <br /> E5L L <br /> PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑REPAIR <br /> Inside Plumbing (#fixtures_) Fee $ Water Well Fee $ <br /> Water Meter(Size_) Fee $ Mechanical Equipment Fee $ <br /> Meter# <br /> Remote# Moving/Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $ <br /> ❑Copper 171 Grading, Filling, etc.) <br /> Municipal Sewer Connection Fee $ . <br /> Fire Fee $ <br /> ❑ PVC ❑Cast �_ Sprinkler System (Fire) Fee $ <br /> MWCC SAC Charge Fee $ Other: Fee $ <br /> On Site Septic System Fee $ After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> The undersigned hereby acknowledges receipt of this limited <br /> permit, including acceptance of all special information, <br /> terms, conditions or requirements written above. The a State Surcharge: Fee $ <br /> undersigned understands and agrees under penalty of law g <br /> that this permit is strictly limited in scope to the work, j U <br /> activity or improvement specified; that this permit does <br /> not grant any authority to do work or activities requiring Total Amount Paid to City Fee <br /> separate permit approvals; and that this permit does not <br /> grant authority to violate any provision of any City <br /> ordinance or State law,rule or regulation.All work shall be <br /> done in strict compliance with all City ordinances,building <br /> codes and/or health department regulations, and shall be This permit is not valid until the proper fee is pa d and <br /> subject to inspection, approval or rejection by the City. It 1S approved b an authorized Cit Official. <br /> Whenever so ordered, the undersigned agrees to correct pp Y Y <br /> any work found to be in violation of the conditions of <br /> this permit. <br /> Signature of Applicant Signature of City Official <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />