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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />,�,,, I(612) 473-7357 <br />Owner Z)"e IVy/LL 4y_1%-S ,111/1 Sj <br />Contractor Pl� Siws <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 8339 <br />Date 2 — /0 -- 86, <br />Address c 3 ��/�J Z.�+Nlt� <br />Address �C�> <br />State License No <br />4!�/S O� SpLt-r— -r.C(/►_S <br />900 s � 5;:1VM-L0L J Tw-y"CIA, �- <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Water !Meter (Size—) <br />Meter# <br />Remote <br />XNEW <br />Fee <br />Fee <br />Municipal Water Connection Fee <br />❑Copper Q <br />Municipal Sewer Connection Fee <br />❑ PVC ❑ Cast <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />❑ ADDITION ❑ REPAIR <br />S Water Well <br />S --- --- Mechanical Equipment <br />Moving /Lifting Buildings <br />5 ! _ _ Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire <br />Sprinkler System (Fire) <br />Fee <br />S <br />Fee <br />S <br />Fee <br />$ <br />Fee <br />S <br />Fee S <br />Fee S <br />Fee S - '�- - Other: Fee S <br />Fee SAfter-the-fact Investigation Fee S <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 />that this permit is strictly limited !n 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 law, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and &hall be <br />abject 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 />Signature of Applicant <br />i <br />7 <br />.I <br />TOTAL <br />State Surcharge: Fee S 5_0 <br />$o <br />Total Amount Paid to City Fee $ /&0_ <br />T!..s permit is not valid until the proper fee is paid and <br />it is approved by an authurized City Official. <br />Signature .%of Ci"ffic;� <br />Code White File Copy Canary -Inspector's Copy Pink - Finance Copy Gold--Applicant'sRecetpt <br />