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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 />Owner <br />Contractor <br />Lo>/vA eg t>o»w <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />Address <br />Address <br />CITY PI RMITNO. ~ 6966 <br />Date 3 -/9<7 '^-7 <br />7> t SS" C a^o Cl !?c L g.. <br />State License No <br />IT RMITTYPF AND FEE:□ NEW J^DDITION □ Rt; PA IR <br />Inside Plumbing ( # fixtures )Fee S On Site Septic System <br />Water Well <br />Fee <br />FeeWater Meter (Size i Fee S <br />Meter # <br />Remote# .Mechanical Equipment Fee <br />Municipal Water Connection Fee S Moving/Lifting Buildings lee <br />O Copper n Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee <br />Municipal Sewer Connection Fee %................ <br />□ PVC □ Cast n Other: .. l-et* <br />MWee SAC Qiarge Fee -After-the-fact Investigation Fee <br />ACKNOWLEDC.LM ENT <br />Tht und«rsttn«d hereby erknowledgef receipt of this limited <br />permit, ificlucUDg AcetptAhee of aO fpeciai informAiion* <br />Urmt, conditions or requirements wiUten shove. The <br />undersigned urMlcrttsnds snd sgrees under penslty of Isw <br />thst this permit is strictly limited *n scope to the work* <br />scUvity or improvement ^eclfled, Uist this permit does <br />ncM grant sny suthority to do work r sctivitics requiring <br />eepsrste permit spprovsli. snd ths* ;hU permit does not <br />igrsnt suthority to vioisie sny provision of «iy City <br />ordinsnce or Slate Isw, rule or regulstion. All work shsU be <br />dune in strict complisnee with sll City ordinimees. huildkig <br />codes and/or health department regulaUoAs, and ihaB be <br />n«biect to inspection, iu>provsl or leiectton by the City. <br />Whenever so ordered, the underiigBtd sgrees to correcl <br />any mink found to be in violsUon of the conilitic»na of <br />Iliis perwiiC <br />Signature af Applican <br />TOTAL <br />Slate Surcharge; <br />Total Amount Paid to City <br />Fee S <br />ZO.o <br />Fee S ^ <br />Fee <br />This pennit is not valid until the proper fee is paid and <br />it is approved by an authorized C ity Otficial. <br />Signature of f>fricia <br />Cudi HU» I Setup)C'aAU)' (V»p)Pfaiii I w«iH« r<>^(rtdd Swept