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GENERAL PERMIT <br />CITY PERMIT NO. 7648 <br />CITY OF ORONO Date <br />P.O.BOX 66 <br />CRYa fAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />'1 1r <br />,. <br />`/ C 71 /� `C._ Address '17 l/ <br />Owner <br />fl �) l Address' <br />Contractor 1 -T <br />City License No.State License No. <br />REMARKS AN SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Water Meter (Size—) <br />Meter# <br />Remote # <br />�iIFW ❑ ADDITION ❑ REPAIR <br />Fee S Water Well <br />Fee S _ Mechanical Equipment <br />Municipal Water Connection Fee S _ <br />❑Copper F_ <br />Municipal Sewer Connection Fre S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S _ <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading. Filling. etc.) <br />Fire <br />Sprinkler System (Fire) <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S After -the -fact Investigation Fee S <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 ur..ferelands and agrees under penalty of law <br />that this permit is strictly limited In scope to the work. <br />activity at improvement speeirted'. that " permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals: and that this permit don not <br />grant authority to Notate any provision of any City <br />ordinance or State taw. 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 sball 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 />Signature of Applicant <br />r <br />TOTAL <br />State Surcharge: Fee S ' SD <br />Total Amount Paid to City Fee SD. -S -Z; <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />• <br />\�,"M'W'A <br />Code: White - File Copy Canary -Inspector's Copy Pink- Finance Copy Gold -Applicant's Receipt <br />