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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO. <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />Date. <br />8001 <br />7'23-3ir <br />Owner M. £> <br />/A ) i /vjContractor. <br />Address. <br />Address tPfir^ <br />City License No..State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />'TjO^'s . /C>t>0 JS-C. <br />/- <br />I <br />PERMIT TYPE AND FEE: ^cTnEW □ ADDITION □ REPAIR <br />Inside Plumbing (Ifixtures__) <br />Water Meter (Size. <br />Meter#___ <br />.) <br />Fee S <br />Fee S <br />Remote #. <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Municipal Water Connection <br />n Copper Q___ <br />Fee $ <br />Municipal Sewer Connection <br />□ pVC DCast Q <br />MWCC SAC Charge <br />On Site Septic System <br />Fee S <br />Fee S <br />Fee S_r2S: <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S <br />Fee $ <br />Fee $. <br />Fee $. <br />Fire <br />Sprinkler System (Fire) <br />Other:_____________ <br />After-the-fact Investigation <br />Fee $, <br />Fee $. <br />Fee $ <br />Fee $. <br />ACKNOWLEDGEMENT <br />Th« undanicncd hmby acknowladdM nccipt of this UmiUd <br />psnnlt. taeludliig oeetptMico of sU spscial Infoimatfon. <br />toms, eondlilons or rsqulrtnmts wdtttB ahovo. Tht <br />undtnlciMd undtnUnds and avaaa undar panalty of law <br />that thla paimlt U strictly United In aeopo to tha work, <br />activity oc bnprovamant vaelllad: that thla pamlt docs <br />not grant any authority to do weak or aetMtlos requiring <br />saparau parrot approvals: and that Uds permit dc<w not <br />grant authority to violate any provision of any aty <br />ordinance or State law. rule or regulation. All work shall be <br />doiM In strict compliance with aU aty ordlnancas. building <br />codes and/or health department regulattons. and shall be <br />aublect to Inspection, approval or tejeetton by tha aty. <br />Whenever so ordered, the underrigned affeea to correct <br />any work found to be In violation of the conditloBs of <br />thle permit <br />Signa of Applicant/ <br />m <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $. <br />jro <br />Fee <br />sx> <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signatur&«fCity Official . / <br />Code: White-File Copy Canary-Inipector’i Copy Pink-Finance Copy Gold-Applicant’s Receipt <br />i