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GENERAL PERMIT CITY PERMIT No 8736 <br /> CITY OF ORONO <br /> OW /') jqS/4 <br /> P.O. BOX 66 Date / <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612)4733-735, (r <br /> 473-7357 � <br /> Owner R � �l_x.(.(/li-i4S Address ("15 G"' "' `'///3 <br /> Contractor 741/LAO-fZ/ C/ t Address <br /> City License No. City <br /> REMARKS AND SPECIAL CONDITIONS <br /> PERMIT TYPE AND FEE: 0 NEW 0 ADDITION 0 REPAIR 0 REMODEL <br /> Inside Plumbing(#fixtures ) Fee $ 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, a <br /> eo <br /> Grading, Filling,etc.) Fee $ <br /> ❑ Copper ❑ <br /> Design Review Fee $ <br /> Municipal Sewer Connection Fee $ Fire Fee $ <br /> ❑ PVC ❑ Cast 0 <br /> MWCC SAC Charge Fee $ Sprinkler System(Fire) Fee $ <br /> Other: /2' -- Fee $ •Ov <br /> On Site Spetic System Fee $ <br /> After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> State Surcharge: Fee $ 5-6 <br /> The undersigned hereby acknowledges receipt of this limited permit, <br /> including acceptance of all special information, terms, conditions or Total Amount Paid to City Fee $ /a/,C/ `5.6-v <br /> requirements written above. The undersigned understands and agrees <br /> under penalty of law that this permit is strictly limited in scope to the work, t//e& / �n3 <br /> activity or improvement specified;that this permit does not grant any ( �/ <br /> authority to do work or activities requiring separate permit approvals;and <br /> that this permit does not grant authority to violate any provision of any City <br /> ordinance or State law,rule 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 City ordinances, building codes and/or health <br /> department regulations,and shall be subject to inspection,approval or by an authorized City Official. <br /> rejection by the City.Whenever so ordered,the undersigned agrees to <br /> correct any work found to be in violation of the conditions of this permit. <br /> Sign • of Applicant <br /> Signature of City Official <br /> Code: White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />