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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CR i _.: AL BAY, MINNESOTA 5 5323 <br />(612) 473-7357 <br />Owner 8ki: rZ <br />Contractor — iCpaq J e.' <br />City License No. <br />REMARKS AND SPECIAL CONDl fIONS <br />CITY PERMIT NO. 7346, <br />Date 1174re-GH / .:3 IVRV <br />V <br />Address <br />Address <br />PERMIT TYPE AND FEE: XNEW ❑ ADDITION <br />Inside Plumbing ( Al fixtures ) Fee S <br />Water Meter (Size ) Fee S <br />Meter # <br />Remote M <br />Municipal Water Connection Fee S <br />❑ Copper a — <br />Municipal Sev, r Connectir <br />❑ PVC ❑ Cast _ <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee S <br />State License No <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />f Grading, Filling, etc.) <br />I Other:_ <br />Fee $ ! After -the -fact Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />psrmit, including acceptance of W special informstlon, <br />terms, conditions or requirements written above. The <br />undersigned understands and &grave under penalty of law <br />that this permit is strictly Umlted 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 low, rule or regulation. AU 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 underslgnvd agrees to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signa of Applicant <br />Code: White -File Copy Canary Inspector's Copy <br />TOTAL <br />Fee S 3 ,�—a+=C <br />Fee <br />S <br />Fee <br />$ <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />State Surcharge: Fee S SV <br />Total Amount Paid to City Fee S 3� <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Siiggnature(of City Oftu gal <br />tom} <br />Pink Finance Copy Gold -Applicant's Receipt <br />