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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, <br />Contractor____ <br />City License No.. <br />u)^f/ <br />CITY PERMIT NO. 8552 <br />Date. <br />Address <br />Address <br />A^iCijp ^cl <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />.<.7 n^pM\iy9r\0 p c X Or\Ply .-P <br />PERMIT TYPE AND FEE: <br />Inside Plun.bing (^fixtures __) <br />Water Meter (Size__ <br />Meter#_____________ <br />□ NEW □ ADDITION □ REPAIR <br />Remote <br />Municipal Water Connection <br />QCopper Q____ <br />Municipal Sewer Connection <br />□ pVC DCast Q. <br />MWCC 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 Fee <br />Fin* 5; _____ <br />Fee S. <br />Ft*i* ^ <br />Sprinkler System (Fire) Fee <br />Other: Fee <br />After-tlie-fact Investigation FeeFet! S <br />ACKNOWLEDGEMENT <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 <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited In scope to the work, <br />activity or improvement Q>ecified: that this permit does <br />not grant any authority to do work or activities requiring <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. AU work shall 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 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 />thU permit <br />_SignaJuiiiuof Annlic^/^ <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S.. 5D <br />Fee S2) j <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signati^of City Official <br />Code: WIiltc-MIc Copy Canary-Inspector’s Copy Pink-Finance Copy ^jold-AppUcant’s Receipt