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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 5532? <br />161 ') 473-7 5 <br />Owner <br />Contractor <br />City License No. <br />CITY PERMIT NO. 7873 <br />Date Z/ /,;� _ S's— I <br />T <br />i .4 1 ri. 01091 V in—Ir ffil )me � - -W. , I <br />Address I <br />State License No. <br />PERMIT TYPE AND FEE: ❑ NF.W ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures____) <br />Water Meter (Size—I <br />Meter# <br />Remote 1 <br />Fee S_ Water Well <br />Fee S —_-- —_ . Mechanical Equipment <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection Fee S - ---- <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S . <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />ing /Lifting Buildings <br />Land Alteration (Excavation <br />Grading. Filling, etc.) <br />ire <br />nkler System (Fire) <br />her <br />Fee S After -the -fart Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all special information, <br />terms, conditions or requirements 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 tc. do work or activities requiring <br />separatepermit approvals: and that this permit does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulaUun. 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 />subiect to inspection, approval or relection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signatu of Applicant <br />TOTAL <br />Fee S <br />Fee S X.M . <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />State Surcharge: Fee S 50 <br />Total Amount Paid to City Fee SJ12sv <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sig t of City Official <br />Code: %4hite -File Copy Canary Inspector's Copy Pink - Finance Copy Cold Applicant's Receipt <br />