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GENERAL PERMIT CITY PERMIT NO. 7647 <br />CITY OF ORONO ��� _ ICA _ <br />P.O.BOX 66 Date <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 J <br />, Address <br />Owner �'l'� %� I S � e� ? �2 <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 />❑ NEW ❑ ADDITION <br />Fee S <br />Water Meter (Size _) Fee S <br />Meter# <br />Remote # <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S <br />On Site Septic System <br />ACKNOWLEDGEbI :NT <br />❑ REPAIR <br />ater Well <br />chanical Equipment <br />oving /Lifting Buildings <br />Grading, <br />Fire <br />(Excavation, <br />ig, etc.) <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Sprinkler System (Fire) Fee S <br />- Other: Fee S <br />Fee S lAfter-the-fact Investigation <br />The undersigned he,eby ack iowledges receipt of this limited <br />permit, including acceptance of ell 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 to scope to the work, <br />activity or improvement specified: that this permit does <br />not Rent any authority to do work or activities requiring <br />separate permit approvals. and that this permit does not <br />Rant authority to violate any provision of any City <br />ordinance or Stag law, rule or regulation. Ali work shell be <br />done In strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shell be <br />subject to Inspection, approval or relection 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 />S' ature f Applicant <br />L 6' > <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee S <br />Fee S <br />This permit is not valid until the proper fee is paid and I <br />it is approved by an authorized City Official. <br />Signature of City Official <br />Code: White -File Copy Canary --Inspector's Copy Pink- Finance Copy Gold —Applicant's Receipt <br />