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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 />CITY PERMIT NO. 8518 <br />Date <br />r"Y.,LG�'112�'yL' Address <br />Contractor �/ <br />Cit' License No. � / State Lit <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Plumbing Ofixtures_) <br />Water Meter (Site_) <br />Meter # <br />Remote # <br />t4 NEW ❑ ADDITION <br />Fee S <br />❑ REPAIR <br />r Well <br />Fee S -- —._ (Mechanical Equipment <br />Municipal Water Connection Fee <br />[]Copper ❑ <br />Municipal Sewer Connection Fee 5 _.30 <br />4 PVC ❑Cast r_ <br />MWCC SAC Charge Fee S _ <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />/Lifting Buildings <br />Land Alteration (Excavation <br />Grading, Filling, etc.) <br />kler System (Fire) <br />her: <br />Fee 5 (After -the -fact Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />permit, Including acceptance of as special information. <br />terms, conditions or requirements written above. The <br />undersigned undenlands and agrees under penalty of law <br />that this permit Is strictly limited in scope to the work, <br />activity or Improvement asseelfled; that this permit does <br />not pant MY authority to do work or activities requiring <br />separate Permit approvals; and that the permit does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. Aa work shall be <br />done In strict compliance with all City ordinances, building <br />co6es and/or health department regulations, and shall be <br />sublet! to Inspection, approval or refection by the City. <br />Whenever an ordered, fit* undersigned agrees to cornet <br />any work found to be In violation of the conditions of <br />this permit. <br />Signature,of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee S ,5 <br />Fee S _,391 Js,C <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 City <br />Code: White -File Copy Canary Inspector's Copy Plrk-Finance Copy Gold -Applicant's Receipt <br />