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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 5532:1 <br />(61?) 473-7357 <br />(N ner <br />I)IC-t <br />* 7 <br />Coll.ractor r <br />('it\ I.icense No. _ <br />9— <br />RFMARKS AND SPEC IAL CONDITIONS <br />PERMIT TYPE: AND FIA <br />In%ide Plumbing 10ixtures <br />❑ N1:W (.ADDI'I RA <br />Water Meter (Site __) 1 �• <br />Meter # <br />Remote I <br />Municipal Water Connection Fcc S_ <br />❑Copper Q� <br />Municipal Sewer Connection <br />❑ I'B'C• ❑ Cast <br />Nt«( C S -V Charge <br />Oil Site Septic; Sy stem <br />ACKNOW'LEDGLNILNT <br />Fee S <br />_._. <br />Fee S _ __ <br />The undersigned herrbv acMnoicledttes receipt of this hrnite,1 <br />permit, including acceptance of all special information, <br />terms, conditions or requirements «ritten above. Thr <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity or impro%ement specified: that this petrnit does <br />not grant anv authority to do work or activities requiring <br />separate permit appro%als. and that this permit does not <br />grant authority to viotate an%- provision of ani• City <br />ordinance or State law, rule or regulation. All work shall be <br />done in strict compUance w•itli all City ordinances. building <br />codes and/or health department regulations. and shall bo - <br />subject to inspection, approval or rejection by the C►t% <br />"*newer so ordered. the undersigned agrees to correct <br />any work found it) lot to %-solation of the conditions of <br />this permit. <br />Signature of Appij�;xnt <br />Code White He Copy Canar) htspector'i Copy <br />7 <br />CIT Y PERMIT NO. 8453 <br />a <br />Date <br />e., <br />�? <br />Address go <br />Address7 S <br />Stats: License No. <br />❑ 1Z I'AIR <br />NV r 11,•11 <br />Mc' 11,1111".11 1--4I111pilrelit <br />oving /Luting 111.111dings <br />Lanni Alteration ( Excavation, <br />Grading, Filling. etc.) <br />Fee S _ <br />Fee S -5-, <br />Fee S <br />Fee S <br />ire Fee S <br />nnkler System (Fire) <br />Fee S <br />her: Fee $ <br />tier -the -fact Investigation <br />I01Al- <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ I <br />Fee <br />Fee <br />This pennit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sign- re of City tidal <br />r <br />-<<-4 <br />I <br />Pink finance Copy Gold - Applicant's~ Receipt <br />