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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />61' 473-7357 <br />CITY PERMIT NO. 7618 <br />Date9- /�_ - / I / <br />Owner <br />• Address _1s.1S� _ z1a� <br />Contractor Address <br />City License No. 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 />❑ NEW ❑ ADDITION <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S __----- <br />❑ Copper n <br />Municipal Sewer Connection Fee S-- <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S _ _2_-- <br />On Site Septic System Fee Ste(/, <br />ACKNOWLEDGEMENT <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 to do work or activities requiring <br />separate permit approvals; and that this pennit does not <br />giant 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 &hall be <br />subject to inspection, approval or rejection by the Citv. <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 />Signatow,4. Applicant <br />KREPAIR <br />Water Well <br />anical Equipment <br />',Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire <br />Sprinkler System (Fire) <br />then. <br />Fee <br />S 3 <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />fter-the-fact Investigation Fee $ <br />TOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee S 36. S <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sign u e of City Offic'� <br />Code: White File COPY Canary- Inspector's Copy Pink —Finance Copy Gold —Applicant's Receipt <br />