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GENERAL PERMIT CITY PERMIT NO. 7896 <br />CITY OF ORONO <br />P.O.BOX 66 Date <br />CRYSTAL BAY, MINNESOTA 55323 <br />(o 12) 473-7357 <br />Owner Address S i < C_GG.ICJ <br />Contractor 1/5+'Yt S <br />— QS Address 1�5 <br />City License No. y#__ /t A State License No. <br />REMARKS AND SPECIAL. CONDITIONS <br />PERMIT TYPE AND FL; <br />Inside Plumbing (Mixtures_) <br />Water Meter (Size—) <br />Meter# <br />Remote # <br />Pq NEW Cl ADDITION <br />❑ REPAIR <br />Fee S Water Well <br />Fee S —__— _ _ _ Mechanical Equipment <br />Municipal Water Connection Fee S _ <br />[]Copper ❑ <br />Municipal Sewer Connection Fee S — <br />❑ PVC ❑ Cast r— <br />MWCC SAC Charge Fee S —_ <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />oving /1 "'• q Buildings <br />ILard Alteidtion (Excavation, <br />Grading, Filling, etc.) <br />ire <br />prinkler System (Fire) <br />tiler: <br />Fee S IAfter-the-fart Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />Permit, including acceptance of all special information, <br />terms, conditions or requirements • ritten above. The <br />undersigned tuAerstands and agrees under penalty of law <br />th.t this permit is strictly limited in scope to the work, <br />activity or improvement ,p*cified: that this permit does <br />not grant any authority to do work or activities repuir.ug <br />separate permit approvals; and that this permit does not <br />grant authority to violate any i rovision of any City <br />ordinance or State taw, rule or regulation. All work shall be <br />done in strict compliance with all City ordinances, building <br />codes midlor health department regulations, and shall be <br />sublect to inspection, approval or rel•eetion by the City. <br />Wbenever so ordered, the unA--signed agrees to correct <br />any work found to be in .,elation of the conditions of <br />this permit. <br />Signature of Applicant <br />TOTAL <br />Fee Scgro . edr <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />$ <br />Fee <br />S <br />State Surcharge: Fee S_ ' <br />Total Amount Paid to City Fee <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature f Cit}• Offi I <br />a _J <br />Code White Idle ('op), <br />Canary - Inspector's Copy <br />Pink -Finance 0K gold -Applicant's Receipt <br />