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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner C, U, &) l l/ i Ca`/» <br />Contractor <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 8517 <br />Date 6 <br />Address / ( Fa , <br />Address <br />State License No <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (# ixtures_) <br />Water Meter (Siz �O <br />Meter# a <br />Remote $ <br />Fee S IMechanical <br />Water Well <br />- <br />Fee S �Equipment <br />Municipal Water Connection Fee S <br />❑Copper n <br />Municipal Sewer Connection Fee S _ _ - <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S <br />On Site Septic System Fee S <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges receipt of this limited <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 wecitied; that this permit does <br />not grant any authority 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. All -:cork shall be <br />done In strict compliance with all City ordinances, building <br />codes andlor health department rt gulatlons, and shall be <br />subfect to inspection. approval or refection by the City. <br />Whenever so ordered. the undersigned agrees to correct <br />any work found to be in �iolatlon of the conditions of <br />this perrr.I*. <br />Signat of A \ lican <br />J <br />g /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire <br />Sprinkler System (Fire) <br />Other: <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee S ! <br />Fee S <br />Fee S <br />r-the-fact Investigation Fee S <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee S LI-16 Q0 <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of City' Offo.' <br />x <br />Code White Ilk Copy Canary Inspextor's Copy Pink -Finance Copy Gold -Applicant's Receipt <br />