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GENERAL <br />PERMIT <br />CITY <br />OF <br />ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />1) <br />Owner _ <br />('ITY I'l RNIIT N0. 6644 � <br />Date y - <br />Address /20 S� S' , nr2oturJ kt:> . <br />Contractor 6.1 P43TL1AXX>..J Co, Address �e*N <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FLL: ❑ Nl W <br />Inside Plumbing ( # fixtures ) <br />Water Meter (Size ) <br />Meter # _ <br />Remote # <br />'1� Qa>ti <br />❑ ADDITION <br />Fee S <br />Fre S <br />Municipal Water Connection Fee $ <br />❑ Copper <br />Municipal Se"'rr ( unneetion Fee S <br />❑ PVC ❑ C.i,t F1 <br />MW('(' SAC ('har_,r Fee S <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 t,, inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agnea to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signature of Appl;cant <br />Code. White I dr Copy Canary Inspector's Copy <br />State License No. <br />--%-e <br />;ZREPAI R <br />On Site Septic System Fee $ <br />2-� <br />Water Well Fee $ <br />Mechanical Equipment Fee $ <br />Moving/Lifting Buildings Fee $ <br />Land Alteration (Excavation, Fee $ <br />Grading, Filling, etc.) <br />Other: Fee $ <br />After -the -fact Investigation Fee $ <br />TOTAL <br />State Surcharge: Fee $ �— <br />Total Amount Paid to City Fee � ZO <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of Ityy Official <br />Pink - finance Cop) <br />(„ rid Applicant's Receipt <br />