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GENERAL PERMIT CITYPERMITNO. g466 ' <br /> CITY OF ORONO / Q�/ <br /> P.O.BOX 66 <br /> Date_ �7 �� ��) ((� <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612)473-7357 <br /> Owner �-2-Cl�t J !��/�-e-�' Address • <br /> Contractor Address <br /> City License No. State License No. <br /> REMARKS AND SPECIAL CONDITIONS <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR , <br /> �side Plumbing (#fixtures_) Fee $ Water Well Fee $ <br /> ater Meter (Size_) Fee $ Mechanical Equipment Fee $ <br /> Meter# <br /> Remote� Moving /Lifting Buildings Fee $ <br /> unicipal Water Connection Fee $ Land Alteration (Excavation, Fee $ <br /> n Grading, Filling, etc.) <br /> ❑Copper <br /> unicipal Sewer Connection Fee $ _ _ <br /> Fire Fee $ <br /> ❑ PVC ❑Cast n � Sprinkler System (Fire) Fee $ <br /> +VCC SAC Charge Fee $ � ther: Fee $ <br /> Site Septic System Fee $ After-the-fact Investigation Fee $ <br /> .CKNOWLEDGEMENT 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 improvement 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 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 /> subiect to insnection, apProval or reiection by the estY. it is approved by an authorized City Official. <br /> Whenever so ordered, the undersigned agrees to conect <br /> any work found to be in violation of the conditions of <br /> this permit. <br /> re of Applicant Signature f City Offici <br /> ��'C�--�?�,- Cc.— � /`,� '�-- , <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />