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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 x ru //�.�_ hinG� <br />City License No. I & <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 7791 <br />Date _-1 —,23 — O <br />Address -3 1/� Re <br />If <br />Address _ J�r�� <br />State License No. <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing 0fixtures_) Fee S Water Well <br />Water Meter (Size Fee S 1,3Q• too Mechanical Equipment <br />MeterjlE / io % <br />Remote Moving /Lifting Buildings <br />Municipal Water Connection Fee S <br />❑Copper r <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge Fee S <br />� On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />permit, Including seeeptance of all special information, <br />terms, conditions or requirements written above. The <br />undersigned understands and agrees under penalty of law <br />that title permit is strictly limited In scope to the wank, <br />activity or improvement specified; that title permit does <br />not pent my authority to do work or activities requiring <br />separate permit approvals; and that this permit does not <br />grant authority to Notate ear provision of ray City <br />ordinance or State law, rule or regulation. AD work @bell be <br />done in strict compliance with all City ordinances. building <br />codes and/or health department regulations. and shall be <br />subject to inspection, approval or rejection by the City. <br />Whenever so ordered. the undersigned apses to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signature of Applicant <br />100, <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />inkler System (Fire) <br />ier: <br />er-the-fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee <br />S <br />Fee <br />$ <br />Fee <br />S { <br />Fee <br />S <br />Fee S !i <br />Fee S _ <br />Fee S <br />Fee S_ I'. <br />Fee S <br />Fee S <br />This permit is not valid until the proper fee is paid and <br />i* is approved by an authorized City Official. <br />Signature of City Official <br />Code: White --File Copy <br />Canary —Inspector's Copy <br />Pink —Finance Copy Gold -Applicant's Receipt <br />