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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO. 6752 <br />Datl' % <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 Owner Address 7Sk-1-6 / Igf <br />Contractor J141kUdress t�d <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 />Fee S <br />Fee $ <br />Municipal Water Connection <br />Fee S <br />[]Copper <br />Municipal ewer Connection <br />PVC ❑ Cast <br />MWCC SAC Charge <br />Fee $ <br />Fee $� <br />ACKNOWLEDGEMENT <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 />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 &hall 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 conditions of <br />thu, permit. <br />i ature plicant <br />Code: White --File Copy Canary Inspector's Cope <br />State License No. <br />4/7-7 <br />❑ REPAIR <br />On Site Septic System Fee $ <br />Water Well Fee S <br />Mechanical Equipment Fee S <br />Moving/Lifting Buildings Fee S <br />Land Alteration (Excavation, Fee $ <br />Grading, Filling, etc.) <br />Other: Fee $ <br />After -the -fact Investigation Fee $ <br />TOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee $ D 5V_ <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Si t e of City Official <br />Pink I inanre l �,pc (,old- Applicant's Receipt <br />