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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 />CITY PERMIT NO. 7663 <br />Date /0.16-,eLl <br />Owner e'�;A-V_j (fdN N e-1- l.` Address _ gU,7D &Ief /.D /2,•'YI-p <br />Contractor 1���/�E N4+�/T Address _ /144*LE- 134- IA J <br />Cite License No. <br />RLMARKS AND SPECIAL CONDITIONS <br />State License No. <br />Irm) cry1 s KC "4 �V ivy -!-V-S TF- Vk <br />PERMIT TYPE AND FEE: %NEW <br />II1tiILIC Plumbing ("fixtures_) Fee S <br />Water Meter (Size_) Fee S <br />Meter# <br />Remote Al <br />Municipal Water Connection Fee S <br />❑ ( upper n <br />❑ ADDITION ❑ REPAIR <br />Municipal Sewer Connection Fee S . <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S . <br />Fee C 7 S <br />The undersigned hereby acknoaledges receipt of this limited <br />Permit. including acceptance of all special information, <br />temu, conditions or requirements written above. The <br />updersianed understands 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 />separates permit approvals; and that this permit does not <br />grant authority to violate any provialon of any Clty <br />ordinance or State 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 />sublect to Inspection, approval or reJection by the Citv. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be io violation of the conditions of <br />this permit. <br />S1, the of Applicant <br />iter Well <br />-- IMechani,al Equipment <br />oving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading. Filling, etc.) <br />ire <br />System (Fire) <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee S <br />Fee S <br />[her: Fee S <br />fter-the-fact Investigation Fee S <br />TOTAL <br />S� <br />State Surcharge: Fee S <br />SV <br />Total Amount Paid to City Fee S _ <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 />Code While I ile Copy Canai) Inspector's Copy Pink—I inance Copy Gold Applicant's Receipt <br />