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No <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner 1 SIlli s,d <br />Contractor J OAJ Pe- 0 /o G <br />City License No, <br />REMARKS AND SPECIAL CONDITIONS <br />- ../Delo SE <br />CITY PERMIT NO. 68601 <br />Date 0-7- <br />Address <br />T <br />Address 6)00Wrk�y'S,/hr <br />Address 9114 S -S-3 <br />State License No. <br />PERMIT TYPE AND FEE: ❑ NEW <br />Inside Plumbing( # fixture ) <br />Water Meter (Size ) <br />Meter # <br />Remote # <br />EW <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper a <br />Municipal Sewer Connection Fee $ <br />❑ PVC [:]Cast n <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee $ <br />The undersigned hereby acknowledges receipt of this Umited <br />permit, including acceptance of as special Information. <br />terms, conditions or requirements written above. The <br />undo gored understands and agrees under penalty of law <br />that thle permit is strictly limited in scope to the work. <br />activity or improvement specified. that this permit does <br />not grant any authouty to do work or activities requiring <br />separate permit approval.: and that thia permit does not <br />grant authority to violate any provision of any City <br />ordinanceor State law, rule or regulation All work @hall be <br />done in sZt compliance with all City orm... 'a, building <br />codes and/or health department regulations, and hall be <br />subject to Inspection. approval or rejection by W City. <br />Whenever to ordered. the undersigned agrees to c.uysct <br />any work found to be in violation of the condition, of <br />this permit. <br />Signature of Applicant <br />Code: While -File Copy canw--hupector's Cov, <br />❑ REPAIR <br />On Site Septic System Fee S <br />Water Well Fee $ <br />Mechanical Equipment Fee $ <br />Moving/Lifting Buildings Fee $ <br />Land Alteration (Excavation, Fee S <br />Grading, Filling, etc.) <br />Other: Fee S <br />After -the -fact Investigation Fee S <br />TOTAL <br />State Surcharge: Fee S A e0 <br />Total Amount Paid to City Fee $/1017.Sl <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />re of Ci <br />nak -Finance Copy Gold -Applicant's Receipt <br />