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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner <br />Contras <br />City Li <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 8004 <br />Date C L/! �? �— <br />Address 0.. <br />Address <br />State License No. <br />PERMIT TYPE AND FEE: 'NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) Fee S IWater Well Fee S &O W <br />Water Meter (Size _) Fee S <br />MeterN <br />Remote # <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 _ <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Mechanical Equipment <br />ng /Lifting Buildings <br />nd Alteration (Excavation, <br />Grading, Filling, etc.) <br />ire <br />rinkler Syste,a (Fire) <br />ther: <br />Fee S lAfter-the-fact Investigation <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 />'bat this permit is strictly Walled in scope to the work, <br />activin <br />ty or improvement specified: that this permit do <br />not pant any authority to do work or activities requiring <br />separate permit approvals; and that this permit does not <br />pnt aauthority to violate soy provision of any City <br />ordinsoce or State law, rule or regulation. All work &bail be <br />does in strkt compliance with all City ordinances, building <br />cod" and/or health department regulations, and shall be <br />w'blott to tnspectloo, approval or rejection by the City. <br />Wbenever so ordered, the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />th" permit. <br />'ure of Applicant <br />TOTAL <br />Fee S <br />Fee S <br />Fee S_ <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />State Surcharge: Fee S -1 5V <br />Total Amount Paid to City Fee S ' !o <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature ty Official <br />', Code: White - File Copy Cain vy-Inspector's Copy <br />Pink -Finance Copy Gold -Applicant's Receipt <br />