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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 />CITY PERMIT NO. 8219 <br />Date I --�) — - OS I <br />Owner Address -7 5`_:S -3(?f n ck �l 1 <br />Contractor17�nf-\ ���-`� }c�� ufF'�� Address <br />City License No. V State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) Fee S <br />Water Meter (Size —) <br />Meter# <br />Remote # <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper ❑ <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />ater Well <br />chanical Equipment <br />/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />■ <br />Fee S <br />Fee $ I <br />Fee S 1 <br />Fee S I <br />ire Fee S <br />r System (Fire) <br />Fee S IAfter-the-fact Investigation <br />The undersigned tereby acknowledges receipt of this limited <br />Permit. Including acceptance of an special information. <br />Comes, conditions or tputnmeats wdttea above. The <br />undersigned undm'-"de and agrees under Penalty of law <br />that ehb Permit is strictly Use ted In scope to the work, <br />activity or improvement gnealflad. that ehb permit does <br />not pant any authority to do work or activities mquMng <br />separate permit approvals; and that fhb permit does not <br />great .1hority to violate nay provision of any city <br />osdiname or State law. rule or regulation. AN work sbaa be <br />done In Wlet compliance with all City ordliameee. building <br />codes and/or health department regulations. and •hall be <br />subleet to Ytapection, approval or ra*ctlon by the City. <br />Whenever so ordered. the undmlped agrees to conies <br />any waft found to be in violation of dw conditions of <br />thb permit. <br />Signature of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S 1 <br />Fee S 1 <br />Fee S <br />Fee <br />Fee <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 Offlci <br />Code: White —File Copy Canary— Inspector's Copy link —Finance Copy Gold —Applicants Receipt <br />