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CITY PERMIT NO. <br />Date <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />Owner tP// * 3^^ O Address -^3/ 0 -) C< S Q> <br />CnnUAjAitt S i C ^^^ress_______ <br />City License No__________^__________________State License No. <br />8411 <br />(lire / <br />rOlA) ^S3Ci <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Pluinbinj: (Ifixtures__) <br />^ NEW □a DDITIO □ REPAIR <br />I ee 5 <br />Water Meter (Si/e <br />Meter# ___ <br />)Fee S___ __ <br />Remote 1 <br />Municipal VN ater Gmnection <br />(tipper n <br />Fee S 30. <br />Municipal Sewer ronnectitm <br />□ pvt □(.1st Q <br />M\V( (• SA( Clurue <br />lee S-- <br />()n Site Septic System <br />Fee $.. <br />I'ee S__ <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land .Alteration (Excavation, <br />(trading. Filling, etc.) <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fire <br />Sprinkler System (Fire) <br />Other:______________ <br />After-the-fact Investigation <br />Fee $ <br />Fee $ <br />Fee S <br />Fee S <br />ACKNOWLEDGEMENT <br />The undeniftned hereby •clinimlrdie* receipt of this limited <br />pemiil. ificludint •rcepUyice of all special Informalion. <br />lcrm», ctmdiiion» >*r requirrmenU \%i1tten abme The <br />underaiAned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the worli, <br />activity or tmpruvement specified; that this permit dot* <br />not grant any authority to do v^ork or acUiidei raqutrtng <br />separate permit approvals, and that this permit doat not <br />grant authority Ut vtoUte any providon of any City <br />ordinance or State law. rule or regulation All work shall be <br />done In strict compliance with all City ordinances, budding <br />codes and/or health department regulatioiM, and shall be <br />niblect to Inspectioa. approval or reieetton by the City. <br />Whenever t4) ordeied. die underdgned agrees to correct <br />any work found to be in violation of the conditions of <br />this permit <br />lUTAL <br />State Surcharge:Fee S .3:0 <br />To;al Amount Paid to City Fee $,33-b^) <br />H'miit is not valid until the proper fee is paid and <br />>roved by an authon/ed City Official. <br />Signature of (it> Of ficial <br />~lh/^))an ( lira <br />7^ <br />■( ude %hltc I ik ( opl ( anar) Insp^ tor *i Cup>Pink ~ I inane e Cop)Gold Appikmnt'i Menpt