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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 />CITY PERMIT NO. 7733 <br />Date _ I / ty 7 ey { <br />Owner.aj-V_C-� Address 3-Y/57 <br />City License No. 0?0a J State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (Mixtures_) <br />❑ NEW ❑ ADDITION <br />Fee S <br />Water Meter (Size_) Fee S <br />Meter# <br />Remote $ <br />❑ REPAIR <br />ater Well <br />Mechanical Equipment <br />/Lifting Buildings <br />Municipal Water Connection Fee S 4Z Land Alteration (Excavation,Grading, Filling, etc.) <br />❑Copper <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />ire <br />Sprinkler System (Fire) <br />Fee S lAfter-the-fact Investigation <br />The undeadWil hereby acknowledges recolpt of this limited <br />permit, including acoeptanae of all special Information, <br />tents, conditions or requirements wdttan above. The <br />undardaned understands and agrees under penalty of law <br />that Shia permit is strictly timiled in scope to the work. <br />activity or hop eovemant rpeeifled; that " permit dome <br />not pant any authostlw to do work or activities revildne <br />espante permit approvals; and that this permit does not <br />VMS authority to violate say provision of any city <br />Ordinance or State law. rule or regulation. AN work, shut be <br />done In strict compliance with all City ordinances, bulMnS <br />code and/or bealth department rogulaticaa, and shill be <br />subject to inspection. approval or rejeetion by the City. <br />Wbenever so Ordered. the undersigned agrees to eoneet <br />any work found to be in violation of the conditions of <br />"permit. <br />Si ture of Ap cant <br />v <br />7r <br />TOTAL <br />State Surcharge: <br />Total Amount, Paid to City <br />Fee S <br />Fee S <br />Fee $ <br />Fee S <br />Fee $- <br />Fee S <br />Fee S <br />�l <br />Fee S <br />Fee S -S'0 <br />Fee S3d.sn <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of -Ifrcial <br />Code: White —File Copy Cmiary—Inspector's Copy Pink —Finance Copy Gold—AppUcant's Receipt <br />