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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. 66631 <br />Date �Z — - 3 — f- 2 <br />Owner mil _ Address 0'a fd 64 <br />Contractor <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FLE: ❑ NEW <br />Inside Plumbing I # fixtures I <br />Water Meter (Size—) <br />Meter <br />Remote # <br />0 ADDITION <br />Fee $ <br />Fee $ <br />Municipal Water Connection Fee $ <br />❑Copper a <br />Municipal Sewer Connection Fee $ <br />❑ Pvc ❑ cast <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee $ 4-'2,s <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 taw <br />that this permit is strictly limited in scope to the work, <br />activity or improvement specified; that this ;3. ioes <br />not grant any authority to do work or activities .ring <br />separate permit approvals; and that this permit ooes 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 />subject 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 Londitions of <br />this permit. <br />SignaMW <br />et: <br />Address <br />State License No. <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Other: <br />After -the -fact Investigation <br />TOTAL <br />Stat,- Surcharge: <br />Total Amount Paid to City <br />Fee <br />5 _ <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ _ <br />Fee <br />$ <br />Fee <br />$ <br />Fee $ <br />Fee $ . GD <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 />14Aa-iLa <br />Jv- <br />Code. While I de Copy Canary Inspector's Copy Pink -I inance Copy Gold Applicant's Receipt <br />