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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. a <br />Date / o _ o-) C�_ � (�-- <br />Owner /I Address / po?5 �� X ,Sj <br />Contractor c 1, Address <br />City License No. • -�(L� r% State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />— / L , O U TlLl) ,( v / — `�) T-Y `, lL ( ; i i, c-) t C t . / L ( i . -\) / *. 71' (A <br />l TC1 i )C-hjt_c�cr,1 U ,�,c lti%. N C✓ <br />IF <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) Fee S Water Well Fee S <br />Water Meter (Size—) Fee S —_ Mechanical Equipment Fee S <br />Meter # <br />Remote # Moving /Lifting Buildings Fee $ <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee <br />On Site Septic System Fee S �75 • �� <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 Umited in seope 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 shell be <br />done In strict compUance with all City ordinances, building <br />Lcodes and/or health department regulations, and shall be <br />sck,lect to Inspection. approval or reiectlon by the City. <br />Whenever to ordered, the undersigned agrees to correct <br />any work found to be in violation of the conditinns of <br />this permit. <br />Signatu of Applicant / <br />Land Alteration (Excavation, Fee S <br />Grading, Filling, etc.) <br />Fire Fee S <br />Sprinkler System (Fire) <br />Fee S <br />ther: Fee S <br />fter-the-fact Investigation Fee S <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S - 5L' ' <br />Fee S S, ' <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signat* of City <br />Code: White file Copy Canary -Inspector's Copy Pink -finance Copy Gold -Applicant's Receipt <br />