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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNKSOTA 55323 <br />(612)473-7357 <br />CITY PERMIT NO. ' 757S • <br />Date <br />Owner TuU Address <br />Contractor y) <br />City License Nn. S <br />/-1 9.0 <br />A/-^rx/n /('r/^ ■ <br />AJdress /nTt'/O //uy /.3 U-^ ' /K !■ <br />State License No <br />REMARKS AND SPECIAL CONDITIONS <br />Ojpu. /^7 Atajh? hi^ <br />PERMIT TYPE AND FEE: <br />Inside Plumbing ( # flxtua's. <br />EW □ ADDITION □ REPAIR <br />Fee S. <br />Water Meter (Size <br />Meter __ <br />.)Fee S, <br />Remote # <br />Municipal Water Connection Fee S. <br />□c opper <br />Municipal Sewer Connection <br />□ pVC ncast D <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 />After-the-fact Investigation <br />Fee S <br />Fee S. <br />Fee S. <br />Fee S <br />Fee $ <br />Fee S. <br />Fee $, <br />ACKNOWLEDGEMENT <br />Tht undenlgned hereby acknowledges receipt of this DTnIted <br />permit, including Mceptence of ail special Information, <br />lams, condUions or requirements written above. The <br />undersigned unoterstands 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 />separate permit approvals; and that this permit does not <br />grant authority to violate any pro\'ision of any City <br />ordinance or State law, rtUe or regulation. All work shall be <br />done In strict compliance with all City ordinances, budding <br />codes and/or health department regulations, and shall be <br />subiect to Inspection, approval or leiection by the City. <br />Whenever so ordered, the undenlgncd agrees to correct <br />any work found to be in violation of the conditions of <br />ibtj permit. <br />Signatare of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ <br />Fee $ <br />SO <br />20 SD <br />This pennit is not valid until the proper fee is paid and <br />V ,4* approved by an authorized City Official. <br />Signa <br />Code Sfhit* I lie Copy f *anar>' Inspet inr** Copy Pink Hnance Copy (iold AppUcanCs Receipt <br />L ^