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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 5533 <br />(61 2) 473-7357 <br />CITY PERMIT NO. 8037 <br />Date <br />Owner _,iCQ/.Address <br />Contractor ,n—�i I t/C� jC(7( ®lI7state <br />ddress <br />:Z2 <br />City License No. /�/License No. )� <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE: AND FEE: *NFW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) Fcr S _" lW'ater Well Fee S <br />Water Meter (Size_) <br />Meter# <br />Remote ti <br />Fre S — ----Mechanical Equipment <br />Municipal Water Connection Fee S _ <br />❑Copper F] <br />Municipal Sewer Connection Fee S - <br />❑ Pvc ❑ (-a.t n <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />owing 'Lifting Building, <br />Fee S <br />Fee S <br />and Alteration (Excavation. Fee S <br />Grading. Filling. etc ) <br />IFire Fee S <br />nkler System (Fire) <br />her: <br />Fee S Citi <br />After -the -fart Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />permit. Including acceptance of W special information. <br />terms. conditions or requirements wdtten above. The <br />undersigned understands and ag-ees under penalty of law <br />that this permit is stricUV limited in scope to the work, <br />activity or Improvement specified: that this permit does <br />not grant any auU.orlty to do work or activities requiring <br />separate permit approvals: and that this permit does not <br />grant authority to violate env 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 andjor health department regulations. and shall be <br />subject to inspection, Lpproval or miectlon 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 />Signature f Applicant <br />L- Code: MbiM—FIM Copy Canary Inspector's Copy <br />TOTAL <br />State Surcharge: <br />k'o.al Amount Paid to City <br />Fee S <br />Fee S <br />Fee S 1 <br />Fee S ' e) ' <br />Fee 2-6 5 <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sign lure of City Ofticia <br />., <br />Pink I inance Cop> Gold Applicant's Receipt <br />