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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />t 612) 473-7357 <br />Owner <br />Contractor t,tirl��) nGi <br />City License No. <br />LJu - <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 7743 <br />Date " -/ _ e-1?-1 I <br />Address 9 e <br />Address YZZ& <br />State License No. <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures) Fee S d Water Well <br />Water Meter (SizeN Fee S . on Mechanical Equipment <br />Meter N <br />Remote #-- Moving /Lifting Buildings <br />Municipal Water Connection <br />❑Copper ❑ <br />Municipal Sewer Connection <br />Fee S �• DOLL nd Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S. :/�•Q� IFire <br />❑ PVC ❑ Cast a_ <br />MWCC SAC Charge Fee S <br />On Site Septic System Fee S <br />ACKNOWLED :EMENT <br />Tha undersigned hereby acknowledges receipt of this limited <br />permit, Including acceptance of all special Information, <br />terms, conditions or requirements written above. The <br />underd=*d 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 does <br />not grant any authority to do work or activities requiring <br />separate permit approvals; and that this permit doom not <br />grant authority to violate any provision 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 />cod" andlor health department regulations, and snail 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 />nkler System (Fire) <br />1 <br />Fee $1 <br />Fee S 1 <br />Fee $1 <br />Fee S 1 <br />Fee S 1 <br />Fee S I <br />her: Fee S <br />fter-the-fact Investigation Fee $ <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $/, S-n 1 <br />Fee S <br />o? 7ST) <br />This permit is not valid until the proper fee is paid and I' <br />it is approved by an authorized City Official. <br />Signature of City Official <br />Code White - File Copy Canary -Inspector's Copy Pink -Finance Copy Gold -Applicant's Receipt <br />