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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 PI RMITNO.7500' <br />l>atc <br />Owner —..j~ ... --------- Address _ ^^0 _____ <br />_£)u<^k^ /V /5y ^ <br />. M« y c <br />Contractor <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />State License No. <br />/'^OD <br />6TD ^i4K^ ^y/fA yhi^in^ ' <br />PERMIT TYPE AND FI I ; <br />Inside Pliinibing( M fixtures <br />Water Meter (Si/e____) <br />Fee $, <br />Fee S, <br />Meter .# <br />Remote # <br />Municipal Water Connection <br />n Copper l~l <br />Fee $, <br />Municipal Sewer Connection <br />□ PVC □ Cast Q <br />Fee S. <br />MWee SAC Charge-Fee S. <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Other:. <br />Fee S <br />Fee S <br />E'ec S <br />Fee S <br />Fee S <br />Fee S. <br />After-the-fact Investigation Fee S <br />ACKNOWLEDGFMFNT <br />The undrraitfi€<1 hereby arknowledfet receipt of thU ttmlted <br />permit, including erceptanre of tU Inforniettoii, <br />termt. (t>nditton» or requirements written sbnve. The <br />underngned understands and agrees under penaltv ol law <br />that this permit is strictly bmiced in scope to the work, <br />activity or improvement specified: that this permit does <br />not grant any authority to do work or aettvidet requiring <br />aeparau permit approvals, and that this permit does not <br />grant authority to violate any provision of any City <br />urdiuance or SUte law. rule or regulaUon. All work shall be <br />done in strict comptience with all City ordinances, budding <br />codes and/of health department regulations, and shall bt <br />fublect to inspectioA, approval or reiecdon by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work ^ound to be in violedon of the conditions of <br />this pemUL <br />TOTAL <br />Sldtc Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Pec S <br />Signature oftAfpl^ <br />C\>de White f gi? (C'aiUjy Ua *i Cop> <br />This permit is not valid until the projH-r fee is paid and <br />it is approved hy an authon/cd City UHicial. <br />Signj)4l^ of City OlTici <br />Fifiii I tnence Copy <*tdd ApplKant « Receipt