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GE ��ERAL PERMIT �ITYPERMITNO. 829'7 � <br /> . .,� <br /> �V1�Y OF ORONO Date " � <br /> - P.O.EOX 66 <br /> CRYSTAL BAY,MINNESOTA 55323 <br /> (612)473-7357 <br /> , <br /> Owner �-� Address ` � � / <br /> Contractor � � �� Address C% �� <br /> City License No. State License No. / �I d7�f/7 c� <br /> REMARKS AND SPECIAL CONDITIONS <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑REPAIR <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 /> Municip 1 Water Connection Fee $�0' 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 /> 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 acceD�ce of ell aDecial informatlon, r,r� <br /> terms, conditions or requirementa written above. The �(J <br /> undersi�►ed understands and a�ees under Penalty of law State Surcharge: Fee $ � <br /> that this permit is strictly limited in ncoDe to the work, <br /> activity or imD�vement apecified; that this permit dcea �.� <br /> not giant any authority to do w�k or activitiea requirtng Total Amount Paid to City Fee <br /> sepazate Dermit approvals; and that this permit doea not <br /> �ant auffiorlty to violate any provislon of any City <br /> ordinance or State law,rule or regulation.All work shall be <br /> done in strlct compliance with all CitY ordivances,building <br /> codea �aior health deDartn►ent re�s�o�. �a �n8u be This permit is not valid until the proper fee is paid and <br /> subiect to inaDection, apvroval or reiectlon by the CitY. it is approved by an authorized City Official. <br /> Whenever so ordered, the undersigaed a�eea to correct <br /> any work 4ound to be in violatdon of the conditiona of <br /> this permit. <br /> Si ature� of Ap lic nt Signature City Offici <br /> . � � <br /> Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />