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GENERAL PERMIT CITY PERMIT NO. 8522, <br />CITY OF ORONO l� __C <br />��r <br />P.O.BOX 66 Date <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 7- / <br />Owner �� O Address5 <br />�I <br />Contractor �1� I Address—'Er2vT f k D <br />City License No. 's f t i AC4- State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />— 7 �D — 7 mil) w�l7r ��rti•.� � �Ce�-t. <br />PERMIT TYPE AND FEE <br />Inside Plumbing ($fixtures._) <br />Water Meter (Size—) <br />Meter # <br />Remote 4 <br />NEW ❑ ADDITION <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper Q <br />Municipal Sewer Connection Fee S _ <br />❑ PVC ❑ Cast El <br />MWCC SAC Charge Fee <br />On Site Septic System Fee S <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges receipt of this limita,l <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 In scope to the work, <br />activity or improvement specified: that this permit don <br />not grant 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 State law, 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 shell 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 />Signal re of Applicant <br />❑ REPAIR <br />Water Well <br />Fee S <br />Mechanical Equipment <br />Fee S <br />Moving /Lifting Buildings <br />Fee S <br />Land Alteration (Excavation, <br />Fee S <br />Grading, Filling, etc.) <br />ire Fee S <br />)rinkler System (Fire) <br />ther: <br />fter-the-fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee S <br />Fee S <br />Fee S ,SCo <br />Fee _�a e�n <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signapre of City official <br />Code- While - File Copy Canary u.spector's Copy Pink —Finance Copy Gold —Applicant's Receipt <br />