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ff <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner 4bn Cam'�- <br />'.r�reo'ractor ��t��_✓0 �� (mil �Q ZZ <br />u4N License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#t*ixtures_) <br />Water Meter (Size_) <br />Meter # <br />Remote I <br />CITY PERMIT NO. 7725 <br />Date <br />Address <br />Address —e4-:2e) g j) <br />State License No. <br />❑ NEW ❑ ADDITION ❑ REPAIR <br />Fee S Water Well <br />Fee S —__-- -_-- Mechanical Equipment <br />Municipal Water Connection Fee S <br />❑Copper Q <br />Municipal Sewer Connection Fe,- S _ - -- <br />❑ PVC ❑ Casl ❑__ <br />MWCC SAC Charge Fee S . <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee 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 law <br />that this permit is strictly limited In 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 />Rant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. All work stall be <br />done In strict compliance with all City ordinances, building <br />codes andior 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 %iolation of the conditions of <br />this permit. <br />Signatu A plic <br />� L�c <br />ing /Lifting Buildings <br />Fee S 4,041 <br />Fee S <br />Fee S`_ <br />Land Alteration (Excavation, Fee S <br />Grading, Filling, etc.) <br />Fire Fee S <br />rinkler System (Fire) <br />her: <br />ter -the -fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee S <br />Fee S <br />Fee S 5-0 <br />Fee '41), s-0 <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signatu • of City Of lcial <br />t odc %hire I ile Copy Canar% Inspector's Copy Pink Finance Copy Gold -Applicant's Receipt <br />