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GENERAL PERMIT CITYPERMITNO. g325 <br /> CITY OF ORONO �, _ � _ , _ <br /> P.O.BOX 66 Date G <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612) 473-7357 <br /> �-� -�y` <br /> Owner � C ` � Address �' � `C..� <br /> 1 �--� . <br /> Contractor � ��ddress � �• � � � ��'l <br /> City License No. �� � State License No. <br /> REMARKS AND SPECIAL CONDITIONS <br /> �_r � � <br /> PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑ REPAIR <br /> �---- <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 n Sprinkler System (Fire) Fee $ <br /> MWCC SAC Charge Fee $ Other: Fee $ <br /> � d C� <br /> On Site Septic System Fee $ After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <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 a�ees under penalty of law State Surcharge: Fee $ <br /> that this permit is strictly limited in scope to the work, �� � <br /> activity or irnprovement specified; that this permit does <br /> not grant any authority to do work or activities requiring Total Amount Paid to City Fee $ � <br /> sepazate permit approvals; and that this permit does not <br /> grant authOriSy to violate any pYOvisiOn 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 /> subiect to inspection, approval or reiection by the c�cy. it is approved by an authorized City Official. <br /> Whenever so ordered, the undersigned agrees to correct <br /> any work found to be in violation of the conditions of <br /> this perxnit. <br /> Signatu of Ap .licant Signature of City Official <br /> ���� �� , � �� �� , <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanYs Receipt <br />