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GENERAL PERMIT CITY PERMIT NO. 8222 <br />CITY OF ORONO <br />Date <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(612) 473-7357 dc <br />1E f� �G� <br />Owner � � � Address v � <br />Contractor �Tf 11 ` Cr Address C' <br />City License No. ' �'� State L;_ense No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEC: M-A-h:W ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) <br />1-ce- <br />Fee <br />%%';Iter deter (Size_) <br />1 -cc <br />ti _ <br />Meter# <br />S <br />Remote 1 <br />Municipal Water Connection <br />Fee <br />S . -- <br />❑Copper F1 <br />Municipal Sewer C'onncction <br />Fee <br />S -- _ <br />0 Pvc ❑ ca't n <br />MWCC SAC Charge <br />Fce <br />S . <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.I <br />-ire <br />Sprinkler System (Fire) <br />her: <br />Fee S lA.fter-the-tart Investigation <br />ACKNOWLEDGEMENT I TOTAL <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance ret all special InformsUon, <br />terms, condition or requirements written above. The <br />undemitned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity or improvement specified: that this permit dues <br />not grant any authority to do ork or activities requiting <br />sep •He permit approvals. and tat this permit does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulaUon. Ali work shall be <br />dune In strict compliance with all City ordinances, building <br />codes and/or health department regulaUons, and shall be <br />subject to Inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />anv work found to be in violation of the conditions or <br />this permit. <br />SignaturC of ApphL:ant <br />( ,ode %hilc I de Cops Canary In%Mtor's Cop) <br />Fee <br />S <br />Fee <br />S <br />Fee <br />$ <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee <br />This pemlit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of City Official <br />i <br />Pink I iname Copy Gold Applicant's Receipt <br />