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GENERAL PERMIT <br />CITY OF ORONO <br />*■ <br />( I I Y IM KMIT NO.719? <br />I'.O.BOX 66 <br />C RYSTAL BAY. MINNl SOTA 55323 <br />(612)473-7357 <br />Owner <br />Conlraclor <br />"Adclrc <br />Address <br />City License No.State License* No. <br />RI MARKS AI>I) .SPI (lAL C ONDlilONS <br />tyLPlaH il ■/nsofioh^ 7b <br />PI RMITTYRI ANUFLK: <br />Inside Plumbing) # fixtures <br />Water .Meter (Si/e i <br />Meter §___________ <br />W <br />-) <br />NLW □aodition D ripaik <br />_________ On Site Septic System <br />Fee S.------------ w ater Well <br />l ee S <br />Remote # <br />Municipal Water C'onnection <br />OCopper n <br />Fee S. <br />Municipal Sewer Connection <br />□ PVC □ Cast Q <br />Fee S. <br />MWee SAC Giarge Fee S, <br />Mechanical l.(|uipment <br />lee S <br />lee <br />Moving/Litting Buildings <br />Land Alteration (I xcavation, <br />(trading. Filling, etc.) <br />I ee S <br />I ee S <br />Other:. <br />After-the-fact Investigation <br />I ee S <br />Fee S <br />ACKNOWLEIK'.KMtNT <br />The underktgfied hereby erknovkledgrt rrrript of ihig Umited <br />permit tnrludini M>reptanc« of all ipecial infomiAtlon. <br />Urmt. condlUnni or requlrtmenu Mriltrn above. The <br />undemgned undertUinda and agr*#t under penalty of law <br />that thia permit la atriclly limited ut acope to the worii, <br />acUvitv or improvement tpeclfled; that this permit doea <br />not grant any authority to do work or acuvitiea requiring <br />•eparau permit approvala. and that thla permit doea not <br />grant authority to vi«jlate anv provtUon of any ntv <br />ordinance or SUU law, rule or regulation. All work ahaO be <br />dune In atnet compUanre with aU City ordtnancea. building <br />codes and/or health department regulationa. and diall be <br />lubiect to Inapacuon. approval or lefectton by the CItv . <br />Whenever ao ordered, the undersigned agrees to correct <br />any work found u> be in violaUcHi of the rondidona of <br />thu permit <br />TOTAL <br />Slate Surcharge:Fee S <br />Total Ajiiount Paid to City Fee <br />this pennit is nol valid until the pioper fee is paid and <br />it is approved by an authorized City Oflicial. <br />Signjj^yi. »)f ( it\ OfftCl <br />(odo Whilf I ikr ( opy ( jnar> liiapet lur't Cupy Pink I inance ( opy <»okl Apptkant'v tcvcip!