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GENI'ERAL PERMIT CITYPERMITNa '799� � <br /> CI'�Y OF ORONO Dt - � <br /> P.O.BOX G6 � � � <br /> CRY'STAL BAY,MINNESOTA 55323 <br /> (612)473-7357 <br /> � ��� 7�5 ��i.P_cts�.� �c�• <br /> Owner Address <br /> Contractor w /,��� �6� . Address <br /> City License No. ��� �7 State License No. <br /> REMARKS A1�1D SPECIAL CONDITIONS <br /> PERMIT TYPfi AND FEE: �NEW ❑ ADDITION ❑ REPAIR <br /> Inside Plumbing (#fixtures_) Fee $ Water Well Fee $ <br /> Water Meter(Size-�� Fee $ - � Mechanical Equipment Fee $ <br /> Meter# �- a <br /> Remote# �� L � � 3 � Moving/Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ 6 • � 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 undersigped hereby acknowledges receipt oY this limited <br /> permit, inclpding acceptance of all special information, �J� <br /> � v <br /> terms, condltiona or reguirements w�itten above. The State Surcharge: Fee $ <br /> undersi�ed understands aad a�ees under Penalty of law <br /> that this permit is strlctly limited in scoDe to the work, <br /> I activity or itnprovement apeciHed; that this permit dces <br /> not �ant any authorlty to do wark or activities requirina Total Amount Paid to City Fee $ <br /> I seperate perqiit agprovals; and that this perniit doea not /�� �A <br /> �ant autho�ty to violate any provta[on of any City � � � <br /> ordinance ox'State law,rule or regulation.All work shall be <br /> done in stric` complience with all City ordinances,building <br /> codes aad/or health deDartmeat regulationa, and ahall be 'This permit is not valid until the proper fee is paid and <br /> subiect to inspection, appzoval or rejection by the City. it is approved by an authorized City Official. <br /> Whenever so ordered, ihe undereigned aarees to correct <br /> any work folund to be in vlolatlon of the conditions of <br /> this permit. <br /> Signatur f Applicant • Signa re of Ci Official <br /> � <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />