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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 />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 6827, <br />Date E2? 7-312 <br />Address <br />Address <br />State License No. <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing ( # fixtures ) Fee $ On Site Septic System <br />R� <br />Water Meter (Sizes ) Fee Water Well <br />Meter # 3U/ 0 3 L27 <br />Remote # /d 0 3s4? Mechanical E tuipment <br />Municipal Water Connection Fee $ Moving/Lifting Buildings <br />❑Copper ❑ Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Municipal Sewer Connection Fee $ <br />❑ PVC ❑ Cast n Other: <br />MWCC SAC Charge Fee $ After -the -fact Investigation <br />ACKNOWLEDGEMENT ICTAL <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance c! all special information, <br />terms, conditions or requircr.ents written above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity or improvement specified; that this permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals; and that this permit does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subject to Inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be in %iolation of the conditions of <br />this permit. <br />Signature of Applicant <br />Code: White --file Copy <br />Cana, <br />vector's Copy <br />Fee $ <br />Fee $- <br />Fee $ _ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />State Surcharge: Fee $ <br />Bp <br />Total Amount Paid to City Fee $ <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature ot'City Ot al <br />l <br />I finance Cop) Gold Applicant's Receipt <br />