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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(613) 473-7357 <br />Owner—A,l �JdvlfeV-2 <br />Contractor <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Plumbing ( # fixtures <br />Water Meter (Size ) <br />Meter # _ <br />Remote # <br />Municipal Water Connection <br />❑Copper ❑ <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast ❑ <br />ONEW <br />❑ ADDITION <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />CITY PERMIT NO. 6'749 1 <br />Date :2,3 <br />Address 44475 ,9/100 i 9 Je • So <br />Address % e <br />State License License No. <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee $ <br />Fee $ �� <br />Fee $ <br />Fee $ <br />Fee $ <br />Other: Fee $ <br />MWCC SAC Charge Fee $ After -the -tart 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 />undersigned 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 />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 />Signature of Applicant <br />u, o <br />Code: White -File Copy Canary —Inspector's Copy <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ ' � <br />Fee $ �? �n <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorizeti City Official. <br />Signatu f City Official <br />Pink — I-inance Copy Gold Applicant's Receipt <br />