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GENERAL PERMIT <br />CITY OF ORONO <br />P.O. BOX 66 <br />CRYSTAL BAY, M1NNESOTA 55323 <br />(612) 473-7357 <br />CITY PERMIT NO. 8340 <br />Date <br />Owner Address afluv nn�-- c'i <br />Contractor /l Address qy3(�, � � P <br />��v M <br />City License No. _ State License No. — <br />REMARKS AND SPECIAL CONDITIONS <br />PERMITTYPE ) E: ❑ NEW ❑ ADDITION <br />Inside PlumbingWixtures_) Fee S <br />Water Meter (SizN q � Fee S <br />Meter li pg 3 / 09 T <br />Remote #_0 <br />Municipal Water Connection Fee S _ <br />❑Copper Q_ _ - <br />-Municipal Sewer Conne, tion Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of s11 speea .1 Information, <br />terms, conditions or requirements •.ritten above. The <br />undersigned understands and Ggreet under penalty of law <br />that this permit is strictly limited Li scope to the work, <br />activity �r imr ovement speufled: the this permit does <br />not grant any authority to do war& or activities requiring <br />separate permit approvals; wid that this permit does not <br />Rant authoritY to v!olate any provial on 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 />codas and/or health department regulations, wtd shall be <br />suh►ec, to inspe^.tion, approval or rejection by the City. <br />Whenever so ordered, the ,.ndersigned agrees to romct <br />.nv work found to be in lioiation u! the conditions of <br />this permit. <br />Signature of Ap/plicant <br />-- — <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire <br />prinkler System (Fire) <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee S <br />Fee S <br />--1Other: Fee S <br />fter-the-fact Investigation Fee S <br />TOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee S 100 <br />This permit .'_ oio! valid until the proper fee is paid -ind <br />it is approved by an ,..ihorized City Official. <br />Signature of City Official <br />('ode. White- Fite Copy Canary Inspector's Copy Pink --Finance ('op) Gold Appticant's Recsipt <br />