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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 <br />Contractor - o Is-- we l <br />City License No. I(/ <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 8080 <br />Date _ __qlqjs <br />Address / (a,3 �J J-eerldc-U_ - <br />Address 1 Q(:f , �-�LL�-� -7 <br />State License No. <br />I <br />PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) Fee S IWater Well Fee S <br />Water Meter (Size —) Fee S <br />Meter# <br />Remote # <br />Municipal Water Connection Fee S <br />❑ Copper n <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast ❑__ <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />ical Equipment <br />/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />nkler System (Fire) <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S IOther: Fee S <br />Fee S !After -the -fact Investigation Fee S <br />The undmigned hereby acknowledges r66801 of thtr limited <br />pa It. Inhwbg wooplaaee of an WNW intoemation. <br />Mes& co"dans or requiresente wdttea above. The <br />undamped understands and @gem under Penalty of law <br />Umt " Permit is strictly tlsiMd in mope to the work. <br />activity or imp eovesan% weeilled; that thte Posit don <br />not pant My authority to do wank at activities requiring <br />0"We" Parnit aPProvak; and that *W Penh does not <br />Rant authority to violate any Provision of any city <br />ordlnSnee or State law. rule or regulation. Ali week shall be <br />do" in Strict eampba"s with am City ordinances. building <br />coda and/or kenith department regulations. and dial be <br />sublet to tyeetion, approval or nlectlon by the City. <br />Whanever so oadned. tie undmigmd epees to correct <br />any work found to be in violation of the conditions of <br />this parmit. <br />Signature of Applicant <br />TOTAL <br />State Surcharge: Fee S'-67� <br />Total Amount Paid to City Fee S �' S0 <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 Official <br />Code: White —File Copy Canary —Inspector's Copy Pink —Finance Copy Gold —Applicant's Receipt <br />