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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473.7357 <br />Owner <br />Contractor <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures`) <br />Water Meter (Size <br />Meter# <br />Remote #_ <br />CITY PERMIT NO. 8259 <br />Date �- �S I <br />Address � � �� �1' Y __5O <br />❑ NEW ❑ ADDITION <br />Fee S <br />Address <br />State License No. <br />❑ REPAIR <br />er Well <br />1 Fee S IMcchanical Equipment <br />Municipal Water Connection Fee S <br />❑Copper ❑ <br />Municipal Sewer Connection <br />❑ PVC ❑cast <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Moving !Lifting Buildings <br />Land Alter^tion (Fxcavation, <br />-- Grading. Filling, etc.) <br />Fee S -- __— (Fire <br />Sprinkler System (Fir_) <br />^ 1 1 <br />Fee S.f�%�'i t ther:___- - - - <br />Fee 5 After -the -fart Investigation <br />The undersigned hereby aeknowledips receipt of this limited <br />permit, including aceepWce of W special information, <br />teres, conditions or repulremonls written above. The <br />undersigned understands and algees under penalty of law <br />that this pertnit is strictly limited in scope to the work, <br />activity or improvement speeined: that this permit don <br />not grant any authority to do work or activities requiring <br />separate permit approvals; and that this permit don not <br />grant authority to violate any provision of any City <br />ordinance or Slate law, rule or regulation. Aa work $hall be <br />done in strict cosnphance with all City ordinances, building <br />codes and/or health deparlinent regulations, and shall be <br />subject to lnspa<tion, approval or rejection by the City. <br />Whenever so ordered, the undersianed agrees to correct <br />any wor: found to be in Aclation of the conditions of <br />this peon it. <br />Signature of Applicant <br />.01. �! r k, "f, <br />TOTAL <br />Fee <br />S <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ <br />Fee S <br />Fee S <br />Fee $ <br />Fee $ <br />Sta:c Surcharge: Fee S <br />Total Amount Paid to City Fee S � t: <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signatyfie of City <br />Code White Idle Copy Canary Inspector's Copy Pink Finance Copy Cold -Applicant's Receipt <br />