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GENERAZ PERMIT CITY PERMIT NO. 7685 <br />CITY OF ORONO Date /G-�G- <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />�e 7�7 Address L C <br />Owner <br />Contractor Address rZI, <br />VU <br />City License No. _ State License No. a 9 y <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Water Meter (Site _ ) <br />Meter# <br />Remote # <br />❑ NEW ❑ ADDITION <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper In <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />n <br />Fee S <br />Fee S `/!!140 <br />The undersigned hereby acknowledges receipt of"limited <br />permit. Including acceptance of all special Information. <br />terms, conditions or requirements wdtten above. The <br />undersigned understands and agrees under penalty of law <br />that thle permit Is strietiy limited to scope to the work. <br />activity or improvement specified. that this permit does <br />not grant any suthodtar 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. Ali work sball be <br />done in strict compliance with all City ordinances. building <br />codes and/or bealth department regulations. and shall be <br />subject 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 />Sattire of 'cant , <br />i <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />!r System (Fire) <br />e-fact Investigation <br />TOTAL <br />State Surcharge: <br />Fee S <br />Fee $ <br />Fee S--j <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Total Amount Paid to City Fee S_1-!5f 5n <br />I <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />SignaturF of City Official \ <br />Code White -file Copy Canary -Inspector's Copy Pink -Finance Copy v Gold -Applicant's Receipt <br />