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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. 6844 ' <br />n.Ttt; <br />Owner, <br />Contractor.Vl/f-Lu^ <br />City License No..t <br />REMARKS AND SPECIAL CONDITIONS <br />Address / 4^ <br />Address ^ 0 / RtJ _____________ <br />State License No. <br />PERMIT TYPE AND FEE: □ NEW □ ADDITION li3^EPAIR <br />Inside Plumbing ( # fixtures ) Fee <br />S a/. OO On Site Septic System Fee <br />Watftr Mfttffr TSiyn Fee Water Well Fee <br />Meter #Fee <br />Remote # <br />Mechanical Equipment <br />Municipal Water Connection <br />ripnpppr n <br />Fee S Moving/Lifting Buildings Fee <br />Land Alteration (Excavation,Fee <br />Municipal Sewer Connection <br />n pvp n Pnet n <br />Fee s Grading, Filling, etc.) <br />Other:Fee <br />MWee SAC Charge Fee !S After-the-fact Investigation Fee <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 />underrigned undersUnds and agrees under penalty of law <br />that this permit is stricUy Umlted 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 does not <br />grant authority to violate any provision of any City <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 />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 />Siwijitiuc o^f y^plicaiv <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S.. s5"2? <br />Fee %ct J'. So <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: Whltc-Hlc Copy Canaiy-Inspcclor’s Copy Pink-I'inancc Copy Gold-Applicant’s Receipt