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7561 <br />^S.3 <br />^£L. <br />uction Plant <br />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 />^/her/ ^ &/)/(iSk/ <br />()uJn^ <br />City License No. <br />REMARKS AND SPEGAL CONDITIONS <br />CITY PERMIT NO.6701 i <br />Date <br />Address <br />Address <br />State License No. <br />(>Z2D. <br />?/ C O <br />•fWt <br />TO MA« <br />•JtO OtCtARl <br />,in AJiO ACCtr <br />t AJiO RfOUM <br />T TM( ilMOCfi <br />f Oi SmiCT OQI <br />JiOlSAlaOtTA <br />ItMRTti <br />PERMIT TYPE AND FEE: <br />Inside Plumbing ( # fixtures, <br />EW □ ADDITION □ REPAIR <br />Fee $ <br />Water Meter (Size <br />Meter # _ <br />,)Fee $. <br />Remote # <br />Municipal Water Connection <br />D Copper n---- <br />Fee $. <br />Municipal Sewer Connection <br />□ PVC □ Cast Q <br />Fee $. <br />MIVCC SAC Charge Fee $. <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 />ACKNOWLEDGEMENT <br />Tht un<l«rtnined hereby «ckruiwl«dtiBt receipt of this limit#d <br />permit* kiciuding Acetpiftne# of lU Informatioii, <br />teimt* condiltoiii or reQuirements wditeii •bov#. Til# <br />und«r«tgned undersUnds gad gmeef und#f p#ngllir of law <br />that thla permit t« ■tiicUy Umllad In acopa to the work* <br />activity Of tonprovement apecifled. that Ihit parmit 'oat <br />not grant any authority to do work or activitiaa raqairing <br />laparala parmit iipprovais. and that thU permit does not <br />Crant authorttv to violate any pfovidon of any City <br />ordtnaaca or SUIa law* rule or regulation. AQ work ah all ba <br />dofta In ttrlet complianaa with all City ordinaneat. bulling <br />eodaa and/or baallb dapartmant regulations* and mad be <br />iublaet to Inapactlon, approval or rtfacboa by lha City. <br />Wkanavar so ardarad« Ika undar^gnad aire#B to corracl <br />any work found to ba tn vtotabem of lha condibona oi <br />tkito parmit. <br />TOTAL <br />State Surcharge: <br />Total! Amount Paid to City <br />« » <br />Fee $ <br />Fee $ <br />Fee $ ^ <br />Fee $ <br />Fee $ <br />i <br />Fee $ <br />Fee $ <br />Fee $.SO <br />Fee IS <br />This permit is not valid until the propel tcc is paid and! <br />it is approved by an authorized ('ity Official. <br />ItuM <br />t Cit> Official <br />rndn: SliiM I *i« r«if>y C«B«fy iBMXtlur^ CupY Paik I (nam« Copy 4miU Apf>ika*lV