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GENERAL PERMIT CITYPERMITNO. ��13 <br /> CITY OF ORONO ,�- <br /> r.O.EOX 66 Date � <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612)473-7357 <br /> Owner � -��:�L-��� Address ��Z��, �A��( S 1 1��y �_ �� <br /> Contractor [raC�41C_,�Lz� A-y Address �c.'x'rL�U/"�� <br /> City License No. State License No. <br /> REMARKS AND SPECIAL CONDITIONS <br /> , <br /> �-- i�� -t—.�r� c ����'� '{ � . 1�/���v�/�z. � <br /> ��rr�-L e2-�{-E'�,'����i v 2---� <br /> ` <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION �ZEPAIR <br /> Inside Plumbing (#fixtures_) Fee $ Water Well Fee $ <br /> Water Meter (Size_) Fee $ Mechanical Equipment Fee $ <br /> Meter# <br /> Remote# Moving /Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ _ Land Alteration (Excavation, Fee $ <br /> � Grading, Filling, etc.) <br /> ❑Copper <br /> Municipal Sewer Connection Fee $ _ <br /> Fire Fee $ <br /> ❑ PVC ❑Cast Q Sprinkler System (Fire) Fee $ <br /> MWCC SAC Charge Fee $ Other: Fee $ <br /> —crts <br /> On Site Septic System Fee $ �=� After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> The undersigned hexeby acknowledges receipt of this limited <br /> permit, including acceptance of all special information, <br /> terms, conditions or requirements written above. The � <br /> undersgned understands and a�ees under penalty of law State Surcharge: Fee � <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 Total Amount Paid to City Fee $ � <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 shall be This permit is not valid until the proper fee is paid and <br /> subject to inspection, approval or reiection by the City. <br /> Whenever so ordered, the undersigned agrees to correct it is approved by an authorized City Official. <br /> any work found to be in violation of the conditions of <br /> this permit. <br /> Sig tur of Ap ' Signature of City Official <br /> ✓ -�}' � r <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />