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GENERAL PERMIT <br />CITY OF ORONO <br />Owner <br />Con tray <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />City License No.- 1 CJS <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 8529 <br />Date <br />� .r <br />Address 621 I � A, <br />- 41"s <br />Address &LT,2yLLza2 <br />State License No. <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures ) <br />Water Meter (Size ) <br />Meter # <br />Remote <br />Fee S (Water Well <br />Fee S -- _ <br />Municipal Water Connection Fee S <br />❑Copper n <br />Municipal Sewer Connection Fee S <br />❑ PVC 4Cast rl <br />MWCC SAC Charge Fee $ <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including ac-eptance of all special information. <br />termc conditions or requirements written above. The <br />undersigned undentands and agrees under penalty of law <br />that this pewMt is strictly Whited in scope to the work. <br />activity or improvement spreified: that this permit does <br />not grant any authority to do work or activities reauidug <br />separate permit approvals- and that this permit does not <br />Want authority to violate any provision of any City <br />ordinance or State law. rule or regulation. All work @ball be <br />done in strict compliance with all City ordinances. building <br />codes and/or health department regulations. and shell be <br />subject to inspection, approval or resection by the City. <br />Whenever to ordered. the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />dos permit. <br />Signature o pplicant <br />echanical Equipment <br />Moving /Lifting Buildings <br />Sq,—j ;-- <br />Laney Alteration (Excavation. <br />Grading. Filling, etc.) <br />Fire <br />Sprinkler System (Fire) <br />Fee $ <br />Fee $ <br />Fee S <br />Fee $ <br />Fee S <br />Fee S <br />Other: Fee S <br />After -the -fact Investigation Fee S <br />TOTAL <br />State Surcharge: <br />Fee S <br />Total Amount Paid to City Fee S 30 - S <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signa*ure of City <br />Code: White - File Copy Canary -- Inspector's Copy Pink -Finance Copy Cold-Applkant's Receipt <br />