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TT- <br />GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO.8570 <br />Date <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612)473-7357 <br />Owner I / hi/ ^ V ( <br />Contractor <br />Address <br />Address <br />o <br />City License No.State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (#ii\tua-s <br />_) <br />□ NEW <br /><y .. . (VJ:s^) S,-2c-2L_L---- <br />Water Meter (Size <br />Meter#___ <br />Fee S_ <br />Remote # <br />ADDITION □ REPAIR <br />Water Well <br />Vtechanical Equipment <br />Moving /Lifting Buildings <br />Municipal Water Connection <br />Q Copper Cl------ <br />Fee $_______ <br />Municipal Sewer Connection <br />□ PVC □ Cast Q <br />MWee SAC Charge <br />On Site Septic System <br />Fee S~ <br />Fee S <br />Fee S, <br />Fee $ <br />Fee S <br />Land Alteration (Excavation. <br />Grading. Filling, etc.) <br />Fee $. <br />Fee $. <br />Fire <br />Sprinkler System (Fire) <br />Other: ____________ <br />Fee $, <br />Fee $ <br />Fee $ <br />After-the-fact Investigation Fee S <br />ACKNOW LEDGEMENT <br />' 1■'r <br />ThP underilfned hereby ecknowledget rectlpl of thli Umlted <br />permtt. Including eccepunce of all fecial Inlonnttlon. <br />teitni. condiUon* or requiremenU wHlten gbov# Tite <br />undenigned undertunds and agree* under penalty of law <br />that ihU permit U •irtcUy UmlUd In acope to the work, <br />activity nr improvement epecifled; that thla permit iwe <br />not grant any authority to do work or actlvltlai requliing <br />MP*r«u p.rmu .pptov.1.; and that thU paimit doa. not <br />grant authority to vloUta any provUdon of any CIW <br />ordinance or SUie law, rule or regulaUon. AU <br />done in ■iricl compliance with all City ordinance*, <br />code* and/or health department reguUtion*. w*** <br />•ubiect to Inspection, approvd or relection by the City. <br />Whenever *o ordered, the undersigned agree* to correct <br />any work found to be In %1oUU..n of the condlUon* of <br />this permit. <br />I i <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ /; .^-0 _ <br />This pennit is not valid untU the proper fee is paid and <br />it is approved by an authorized City Official. <br />SignajOje^ City Official <br />( ode While I ile Copy Canal) Lnspecior’* Copy «nk -1 inanca Copy Gold-AppHcttty »««»pl