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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) t73-7357 <br />Owner c o <br />Contractor !/k� <br />V� <br />City License No. SU � <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Water Meter (Size—) <br />Meter# <br />Remote N <br />/ <br />❑ NEW ❑ADD'DIIT�I�O�N <br />Fee S nom;%• <br />Fee S___ —_ <br />Municipal Water Connection Fee S <br />❑Copper 0 <br />Mutci I Sewer Connection Fee S <br />PVC ❑ Cast <br />MWCC SAC Charge Fee S _.. <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />The undersigned hereby acknowledges reeegpt of this limited <br />Permit. Including sacsptanee of all special Information. <br />tome, eonditiope or require rents written above. The <br />undersigned undentands and aper under Penalty of low <br />that New Permit is sY/elly, limited In scope to the work. <br />activity v ImProvem.nt ,pried; that this Permit don <br />not pont any "chorda to do work or activitir requiring <br />separate permit approvals: and that this permit dor not <br />pant authority to violate My provision of any City <br />ordinance or State law. rule or regulation. AN work @hall be <br />done In efekt emoplWee with all City ordtaaner, banding <br />eaNs andlor bealth department repsletions, and skaa be <br />subject to Inspection, approval or teeetion by the City. <br />Whenever r ordewd. dw undersigned sprees to cornet <br />any work found so be In violation of the conditions of <br />flue permit. <br />CITY PERMIT NO. 81232 <br />Date !`_9 _f/_—S <br />Address �f ��� &07.( Agri J5 & ' 0 <br />1 <br />Address �/ �<}.v rCZTC.-k' <br />State License No. <br />❑ REPAIR <br />ater Well <br />echanical Equipment <br />oving /Lifting Buildings <br />nd Alteration (Excavation, <br />Grading. Filling, etc.) <br />kler System (Fire) <br />r -the -fact Investigation <br />TOTAL <br />State Surcharge: <br />Fee S <br />Fee S <br />Fee S <br />Fee $ I <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee $� <br />Total Amount Paid to City Fee S <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />City <br />Code White Idc(opy Canary Inspector's Copy pink -FklminCopy Gold - Applicant'sReampt <br />