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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 4733-7-157 <br />Owner ��e,�tZ— "cep , <br />Contractor DO,C] 5T!)4eU /A <br />City License No. l & <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: IM NEW ❑ ADDITION <br />Inside Plumbing (itffixtures_) Fee S <br />Water Meter (Size_) Fee S <br />Meter# <br />Remote <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection <br />❑ PVC ❑ Cast <br />MWCC SAC Charge <br />On Sits Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />Q <br />Fee S . _. <br />Fee S <br />The undersigned hereby acknowlsdps receipt of this limited <br />permit. Imcludhia acceptance of all special Information, <br />terms, coaditions or requirements written above The <br />urtdersiiwod understand said agrees Ender penalty of law <br />tha' this permit is strictly limited in scope to the work, <br />activity or improvement specified. that this permit don <br />not grant any authority to 4o wag or actl ltin requiems <br />separ&te permit approvals, and that this permit does not <br />Want authority to vtuiate any provialim of any City <br />ordinance or 8 to law, rule as re on. AO work shall be <br />dome to strict compUarice wick ap City ordinances, budding <br />codes red/or health department regulations, and @tall be <br />subiect to Iri paetion, approval w refection by the City <br />*'%*novel as ordered, the undo geed &peer to correct <br />any w; rk found to be in .tolouon of the conditions of <br />this permit. <br />Signature of Applica <br />CITY PERMIT NO. 8386 <br />1� <br />Date 3 rO 6 <br />Address �S-��7/1S _ & <br />Address S 3n ux 7 kow'se.47 <br />State License No. <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving .'Lifting Buildings <br />Land Alteratior. (Excavation, <br />Grading, Filling, etc.) <br />Fire <br />Spnnkler System (Fire) <br />Fee S <br />t-ee S <br />Fee $ <br />Fee S <br />Fee S <br />Fee S <br />ther: Fee S <br />fter-the-fact Investigation Fee S <br />TOTAL <br />State Surcharge. Fee $ <br />Total Amount Paid to City Fee Ste` <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 Cit% OfficlAl <br />Coif WMW - FYa Copy Cwrr - kwill kart copy FW - i• inan _ e ( opt i .+Ad 4pptu an, Rrcr f <br />