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CITY PERMIT NO. 8030 <br />GENERAL PERMIT <br />CITY OF ORONO Date <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner 01-9 Address �7 2't-/'I_/ RU <br />Contractor N e aAddress <br />City License No. �L 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 />Municipal Water Connection <br />❑Copper a <br />Municipal Sewer Connection <br />C�f VC ❑ Cast <br />MWCC SAC Charge <br />On Site Septic System <br />NEW ❑ ADDITION <br />Fee S <br />Fee S <br />Fee S <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving 'Lifting Builnings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S moo IFire <br />n <br />Fee S _ <br />kler System (Fire) <br />Fee S lAfter-the-fact Investigation <br />ACKNOWLEDGEMENT I TOTAL <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all special information, <br />terms, conditions or requirements wdtten above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly Welted 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 permit does not <br />grant authority to violate any provision of any city <br />ordinance or State taw, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codas snd/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 />any work found to be in violation of the conditions of <br />this permit. <br />Sign re of Applicant <br />�--- <br />Fee $ <br />Fee S <br />Fee $ <br />Fee $ <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />$ <br />State <br />Surcharge: Fee $ , S0 <br />Total Amount Paid to City Fee Sr&' <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature pf City Offici <br />Code: White —File Copy Canary --Inspector's Copy Pink —Finance Copy i Gold —Applicant's Receipt <br />