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GENERAL PERMIT CITY PERMIT NO. soli <br />CITY OF ORONO Date <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner A4Address <br />' 3 <br />Contractor Address <br />City License No. t� a' State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: X NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) Fee S <br />Water Meter (Size—) <br />Meter# <br />Remote # <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 <br />On Site Septic System Fee S <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges receipt of this lunited <br />permit. Including acceptance of all Woetal information. <br />terms, conditone or requirements written above. The <br />undersigned undantand@ and agrees under penalty of law <br />that this permit is strictly limited in scope to the work. <br />ectivit- • Improvement specified: that thls permit don <br />gr <br />an ant any authority to do work or ectivides requiring <br />separate permit approvals; and that this permit does not <br />Want authority to violate my provision of soy City <br />ordnance 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 resu4tlons, end shalt be <br />subject to Inspection. approval or rejection by the city. <br />Whenever so ordared, the undersigned agrees to comet <br />any work found to be In violation of the conditions of <br />this permit. <br />ater Well <br />echanical Equipment <br />oving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />ire Fee S <br />rinkler System (Fire) <br />Fee S <br />ther: Fee S <br />fter-the-fact Investigation Fee S <br />TOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee $ % <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />of City <br />Code: White - File Copy Canary Inspector's Copy Pink -- Finance Copy <br />Gold -Applicant's Receipt <br />