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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 47 7357 ^c <br />Owner w Address <br />Contractor Address <br />� City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing ( # fixtures ) <br />Water Meter (Size ) <br />Meter # <br />Remote # <br />NEW ❑ ADDITION <br />Fee $ <br />Fee $ <br />Municipal Water Connection Fee $ <br />❑ Copper n <br />Municipal Sewer Connection Fee $ <br />❑ PVC ❑ Cast ❑ <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee $ <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 r' -•ly limited In scope to the work. <br />activity or improve) specified: that this permit does <br />not grant any autho. . to do work or activities requiring <br />separate permit approvals: and that this permit does not <br />grant authority to violste 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 />sublect 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 />Si ature of Applicant <br />CITY PERMIT NO. 6773, <br />����--- <br />Date _ _ <br />State Licenst. �o <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 />State Surcharge: <br />Total Amount Paid to City <br />el <br />Fee S <br />Fee <br />S ae(L• v� <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />S <br />Fee <br />S <br />Fee $•sb <br />Fee Sy <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />S' a ur of City Official <br />Code: White File Copy Canary Inspector's Copy Pink - I inance Copy Gold Applicant's Receipt <br />