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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 />Owner niku <br />Contrsctor1/Jc A\ <br />City License No-----ILM--------------------- <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 8045 <br />^jAudl6 /f<^Datej <br />Address 1^IPs/' <br />Address_____________t __________________ <br />State License No.. <br />PERMIT TYPE AND FEE: ^^NEW □ ADDITION □ REPAIR <br />Inside Plumbing (#nxturcs __) <br />Water Meter (Size—) <br />Meter# <br />Remote #. <br />Municipal Water Co.mection <br />□copper □____ <br />Municipal Sewer Connection <br />□ pVC GCast Q. <br />MWee SAC Charge <br />On Site Septic System <br />Fee S Water Well Fee <br />Mechanical Equipment Fee <br />Moving /Lifting Buildings Fee <br />Land Alteration (Excavation, Fee <br />Grading, Filling, etc.) <br />Fire Feerec 5 <br />Fpp <br />Sprinkler System (Fire) Fee <br />Other: Fee <br />After-the-fact Investigation FeeFee S. <br />ACKNOWLEDGEMENT <br />The undevsifned hereby acknowledges receipt of this limited <br />permit* including acceptance of all 9edal Information, <br />terms, conditions or lequiiemenU wdttcn above. The <br />undersigned understands and agrees under penalty of law <br />that thU permit is stricUy 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 requiting <br />separate permit approvals; and that this permit does not <br />grant authority to violate any provision of any City <br />ordinance or SUte 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 <br />subject to inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signatim s>f Applicant <br />TOTAL <br />State Surehaige: <br />Total Amount Paid to City <br />Fee X -SG <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 of City Official <br />\(A>y\A:a^4k (£P) <br />Code: White-File Copy Canary-Cnipcctor ’i Copy Pink-Finance Copy Gold-Applicant's ReMpt