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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(6' -) 473-7357 <br />CITY PERMIT NO. 7138 <br />Date 7- 6 -� <br />Owner <br />.5A,,i►J 0 L ,S TIEW <br />Address <br />0 9O <br />FA?z#,/P in. I-Afjw <br />Contractor LAJ <br />I b m jj-& K2v $ <br />Address <br />SrQ;N G <br />� )c <br />City License No, <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />1� C; R l <br />— JibO s 9'C,r".c 141 s ANe W N 412�� 9C]!!-K <br />PERMIT TYPE AND FEE: X NEW ❑ ADDITION <br />ln,.ide Plumbing ( # fixtures ) Fee S <br />Water Meter (Size_,) <br />Meter # <br />Remote # <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper Q <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast <br />MWCC SAC Charge <br />AC'KN04LEDGEM ENT <br />Fee $ <br />The unnersigned 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 specified; that this permit does <br />not grunt any authority to du 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 work &hall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health 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 />.ny work found to be in violation of the condltions of <br />his permit. <br />Signatu of Applicant / <br />❑ REPAIR <br />00 <br />On Site Septic System Fee S <br />Water Well Fee S <br />Mechanical Equipment Fee S <br />Moving/Lifting Buildings Fee S <br />Land Alteration (Excavation, Fee S <br />Grading, Filling, etc.) <br />Other: Fee S <br />After -the -fact Investigation Fee S <br />TOTAL <br />State Surcharge: <br />Fee <br />S <br />- D <br />Total Amount Paid to City <br />Fee <br />S <br />3 S Sn <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signatur ity Ofticia <br />Code. White - File Copy Canary - inspector's Copy Pink I inance Copy Gold Applicant's Receipt <br />