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GENERAL PERMIT <br />CITY PERMIT NO. 8511 <br />CITY OF ORONO <br />P.O.BOX 66 Date <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner Q- Address �� L% <br />Contractor' V Address <br />City License No. zsw/ State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />< 7 IA c /l c ( Gr L't, <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Water Meter (Size <br />Meter# _ <br />Remote #_ <br />❑ NEW <br />Fee S <br />❑ ADDITION ❑ REPAIR <br />r Well <br />Fee S --- _--- IMechanical Equipment <br />Municipal Water Connection Fee <br />❑Copper ❑ <br />Multici al Sewer Connection Fee S'- <br />VC ❑ Cast F1 <br />MWCC SAC Charge Fee S <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee <br />The undersigned hereby acknowledges receipt of this Unified <br />permit. including acceptance of ell special Information, <br />terms, conditions of requirements written above. The <br />undersigned unckntands and agrees under penalty of law <br />that Nis permit is strictly limited in rope to the work, <br />activity or improvement specified: that this peraell don <br />not grant any authority to do work or activities requiring <br />aepante permit approvals: and that this permit does not <br />grant authority to violate any provision of any City <br />ordinance Of State law, rule or regulation, All work shall be <br />done in strkt compUance with AN City ordinances, building <br />cocks and/or health department regulations, and shelf be <br />subject to hupection, approval or reaction by the City. <br />Whenever so ordered, the undersigned agrees to comet <br />MY work found to be in violation of the conditions of <br />Nu permit. <br />/Lifting Buildings <br />ind Alteration (Excavation, <br />Grading, Filling, etc.) <br />rinkler System (Fire) <br />fter-the-fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee <br />Fee <br />S <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature-gKity Official <br />Code. White -File Copy Canary 161vpector's Copy Pink -1 inance Copy Gold -Applicant's Receipt <br />(, <br />