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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />� (6!2)473-7357 <br />CITY PERMIT NO. 6899 1 <br />Date r— _ 7 — do �-- <br />Owner Address -7 S /�. <br />// L �1 <br />Contractor _ Address 3 Cv kll 44,6 1 /0 i ��`-r1t <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION <br />Inside Plumbing ( # fixtures ) <br />Water Meter (Size ) <br />Meter # _ <br />Remote # <br />Municipal Water Connection <br />❑ Copper r <br />Fee $ <br />Fee $ <br />Fee $ <br />Municipal Se'.: er Connection Fee $ <br />❑ PVC ❑ Cast 1] <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee $ <br />The undersigned hereby acknowlddges receipt of this limited <br />Permit, including acceptance of as 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 to 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 does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />abject 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 />S�a11)re f Ap,)l' t�� <br />State License No. <br />dREPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee <br />$ C" <br />Fee <br />$ <br />Fee <br />$ <br />I <br />Fee <br />$ <br />Fee <br />$ <br />Other: Fet; $ 1 <br />After -the -fact Investigation Fee $ <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ _5_0 1 <br />Fee $1 e 1 <br />This permit is not valid until the proper fee is paid and <br />it is o )proved by an authorized City Official. <br />Signature of City Official <br />Cote: White --fits Copy Canary —Inspector's Copy Pink -1 inane Copy Gold -Applicant's Receipt <br />