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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />" '' (HKi,Owner. <br />Contractor ( X <br />Address. <br />Address. <br />City License No.. <br />CITY PERMIT NO. 8090' <br />n..„ <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: ^ <br />Inside Plumbing (#flxtua*s__) <br />Water Meter (Size—) <br />Meter# <br />^ NEW □ ADDITION <br />Fee !s _ _ <br />□ REPAIR <br />Water Well Fee <br />Fee <:Mechanical Equipment Fee <br />Remote#Moving /Lifting Buildings Fee <br />Municipal Water Connection <br />ncnppi'T n <br />Fee .C Land Alteration (Excavation,Fee <br />Grading, Filling, etc.) <br />Municinal Sewer Connection <br />i^PVC Dcast n <br />MWee SAC Charge <br />Fire FeeFee 5 J <br />Fee S <br />Sprinkler System (Fire) <br />Other; <br />Fee <br />Fee <br />On Site Septic System Fee S After-the-fact Investigation pP0 <br />ACKNOWLEDGEMENT •TOTAL <br />; i <br />The undertigned hereby ecknowlcdgei receipt of thUUmlUd <br />permit. Including accepUnce of all ipeclal Infonnalion. <br />teims, conditions or requirements unltten above. The <br />undersigned undcntands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity or improvement specified: that this permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals: and that this permit docs not <br />grant authority to violate any provision of any City <br />ordinance or State law, nile or regulation. All work ahaU be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subiect to Inspection, approval or reiection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be in \iolation of the conditions of <br />this permit <br />Signally of Applicant / • ^ <br />\ <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S ^60 <br />Fee <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature oi City Offici^ <br />V <br />Code: White-Rlc Copy Canary-Inipcctor’s Copy Hnk-FInancc Copy Gold-Applicant's Receipt