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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(6121473-7357 <br />CITY PERMIT NO. 8039 <br />Date fie _So <br />Owner. A111198 hk:� Z Address Gni 1t%1 �f �� ��_ 4 -. <br />Contractor D11 a.� e _ �; � '/ Address i/,A) l��r/ �G'Lt%%/ <br />City License No. �D� f% �or _ __ __✓ State License No. > <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Water Meter (Size—) <br />Meter/% <br />Remote <br />EW <br />Fee S <br />❑ ADDITION <br />Fee S _ <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S _ - _ <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving !Lifting Buiidings <br />Land Alteration (Excavation, <br />Grading, Filli,,g, etc.) <br />Fire <br />Fee <br />S <br />Fro, <br />S <br />Fee <br />Ste_ <br />Fee <br />S <br />Fee S <br />(—] Sprinkler System ( Fire) Fee S <br />Fee S. Other: Fee S <br />Fee S 7�'QC% After -the -fart Investigation Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all spatial information, <br />terms, conditions or requirements written above. The <br />undersigned under*[ -ads and agrees under penal'. 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 aporovaW and that this permit does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. Ali 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 />anv work found to be In violation of the conditions of <br />this permit. <br />Signof Applicant . <br />�z ► cn / l L <br />TO7 AL <br />State Surcharge: <br />Total Amount Paid to City <br />F ee S' <br />Fee S -7 G> 0c) <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sign �- of City Offici <br />CRP � <br />Code White - File Copy Canary - Inspector's Copy hink- Finance Copy Gold -Applicant'; Receipt <br />