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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 />Owner 1 <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 />CITY PERMIT NO. 8249 <br />Date /?- '_'?y <br />Address %,-:;?C S So '&au. "' ec/. <br />Address <br />❑ NEW ❑ ADDITION <br />Fee 3 <br />Fee S <br />Municipal Water Connexion Fee S <br />❑Copper ED <br />Municipal Sewer Connj� tion Fee S - <br />❑ PVC f[l'dst ❑ p, Gla <br />MWCC SAC Charge //�� Fee S <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />The undersigned hereby acknowledges recelpt of title limited <br />permit. including acceptance of all special Information. <br />terms, conditions or requirements written above. The <br />undersigned understands and &greet under penalty of law <br />that this permit to striedy limited in .cope to the work. <br />activity or improvement specified: that this permit does <br />not pant say authority to. do work or activill t requiring <br />separete permit approval: and that this permit does not <br />pant authority W violate any provision of any city <br />ordlnmes or State law, rote or regulation. All work shall be <br />done in strict compWnce with Y City ordletanea, building <br />codes and/or health department regulations, and Mas be <br />subject to Inspection, approval or nNetion by the City. <br />Whe over w ordered. the undersigned epees to comet <br />soy work found to be in violation of the conditions of <br />this permit. <br />ture of Ap •tlicant <br />State License No. <br />❑ REPAIR <br />iter Well <br />!chanical Equipment <br />wing /Lifting Buildings <br />nd Alteration (Excavation, <br />Grading, Filling, etc.) <br />re <br />rinkler System (Fire) <br />her: <br />'ter -the -fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee <br />S <br />Fee <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S_ <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />/-� 'i <br />Fee $ <br />Fee $ C:30 SPI <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature f City Official <br />i <br />Code: White -File Copy Canary --Inspector's Copy Pink -Finance Copy Gold -Applicant's Receipt <br />