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GENERAL PERMIT CITY PERMIT NO. ?688 <br />CITY OF ORONO <br />P.O.BOX 66 Date L <br />CP.YSTAL BAY, MINNESOTA 55323 <br />Z12)_473-7357 �/& ! /cOu%erAddress 57 mot- Q.S �/� z-C .J <br />Contractor ZAICI Address 366Ll 6 <br />City License Nc. V State I icense No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Wati-r Meter (Size—) <br />Meter# <br />Remote# <br />NEW ❑ ADP'ATION <br />Fee S — <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast n _ <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />Fee S <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire <br />Sprinkler System (Fire) <br />c-- Dther: <br />Fee S (After -the -fact Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />Permit. including acceptance of all special information, <br />terms, conditions or repuirementa 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 />acuvity or improvement %Decitted; that this permit does <br />not grant any authority to do work or activities requiring <br />separate parmil approval; and that this p^rmi: does not <br />grant authority to violate any proWsion of any City <br />ordinance or State law, rule or regulation. Ali work shall be <br />done In strict compliance with all City ordinances, building <br />codes and+or health department-eguiations. and shall be <br />sub)ect to Inspection, approval or resection by the City. <br />Whenever so ordered, the undersigned agrees to comet <br />any work found to be in violation of the conditions of <br />this permit. <br />S' Appli a <br />Code.White- FileCopy Canary -Inspector's Copy <br />TuTAL <br />Fee S <br />Fee S <br />Fee $_ <br />Fce S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee $ -0 <br />ThiF permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signdilufe of City Official <br />�e <br />pink -Fin •nce Copy Gold -Applicant's Receipt <br />