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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. 7286 <br />Date i -s--gel <br />Owner Address Sln Fpre sT� A to m s LA <br />Contractor1: Address !"!' k 1�'[ AJ <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FLE: 0"NEW <br />Inside Plumbing I # fixtures I <br />Water Meter (Size ) <br />Meter N <br />Remote 0 <br />0 ADDITION <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewt r Connection Fie S <br />❑ PVC D cast Q <br />MWCC SAC Charge <br />ACKNOWLEDGLM ENT <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 />Fee S <br />Fee S Ge <br />AD <br />Fee S <br />Fee S <br />Fee S <br />Other: Fee S <br />Fee S_ I After -the -fact Investigation Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />permit. Including at:teptance of an special information. <br />terns, conditions tw requirements written above. The <br />undersigned understands and "nag under penalty of law <br />that this permit is strictly limited in scope to the work. <br />activity or improvement specified: that We permit does <br />oat pant any authority to do work cr activities requiring <br />separate permit approvals: and that this permit does not <br />pant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. All work shall be <br />done In strkt compliance with all City ordinances, building <br />codes and/or health department regulations. and shadl bt <br />sub)ect to Inspection, approval or m)ecUon by the City. <br />Whenever to ordered, the undersigned epees to cormet <br />an) work Hwrnd to be in violation of the conditions of <br />this permit. <br />Signature of Applicant <br />TOTAL <br />State Surcharge: Fee S • S'0 <br />Total Amount Paid to City Fee S .20. SO <br />This pennit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />SiRna <br />( ode While I do Copy Canary Inspector's Copy <br />Pink I inance Cops <br />Gold - Xpplicant's Receipt <br />