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GENERAL PERMIT <br />CITY OF ORONO <br />Owner <br />Contrac <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(613) 473-7357 <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 />Municipal Water Connection <br />❑ Copper <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast Q <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />❑ ADDITION <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee S. <br />The undersigned hereby acknowledges receipt of this limited <br />Permit, including acceptance of all special Information, <br />term^ 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 W do work or activities requiring <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 shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subject to inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />aril, work found to be in violation of the conditions of <br />Address <br />Address <br />CITY PERMIT NO. 66921 <br />Date �� —e <br />State License No. <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Other: <br />After -the -fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ S"61 <br />Fee $ C_ r_ . Sa <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signatjlre of City Offic <br />rf2 <br />Code White I tic Copy Canary Inspector's Copy Pink - Finance Copy Gold Applicant's Receipt <br />