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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. 7702 <br />/A/? -^-4/ <br />Owner CZA tC^L __ <br />Contractor /a] ir>/yiencL. . <br />Address ^ ^ <br />A.-jda*ss —Af_____________ <br />City License No.State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />/CytX> jjl <br />7:ST>—laX__T>£t^i/AJ _____________ <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (Affixtures__) <br />Water Meter (Si/e__) <br />Meter# ______________ <br />□ NEW □ ADDITION ^K(r EPAIR <br />Fee S <br />Fee S <br />Remote # <br />Municipal Water Connection <br />n Cop pe r r~i <br />Fee S_ <br />Municipal .Sevvci Connection <br />□ PVC □ Cast Q <br />MWee SAC Charge <br />On Site Septic System <br />Fee S- <br />Fee $- <br />Fee S <br />cre> <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation. <br />Grading. Filling, etc.) <br />Fire___________________ <br />Sprinkler System (Fire) <br />Other:_____________ <br />After-the-fact Investigation <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledgei receipt of this limited <br />permit, including sccepUnce of ell 9«cial information* <br />terms, conditlnns or requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />actisity or improvement specified; that this permit does <br />not grant any authority to do work or actisities requiring <br />separate permit approvals: and that this permit does not <br />grant authority to vic»late 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 />subiect to inspection, approval or reiecdon 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 />Signamre of Applicapt / / <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee $ <br />so <br />This pennit 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 />Pi <br />Code. While - I ik Copy Canary Inspcclor ’s Copy Pink-Finance Copy Gokl-Appikiat*i Receipt