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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 5.1323 <br />(612) 473-7-7,3p57� <br />OwnerC <br />OTF <br />ldl <br />Contractor �-p� <br />City License No. o" , n <br />REMARKS AND SPECIAL CONDITIONS <br />J2�� <br />PERMIT TYPE AND FEE: <br />�J NEW <br />/\ <br />Inside Plumbing (#fixtures_) <br />Fee <br />Water Meter (Size—) <br />Fee <br />Meter # <br />Remote # <br />icipal Water Connection <br />Fee <br />[]Copper <br />Muni •ipal Sewer Connection <br />Fee <br />❑ PVC [7 Cast <br />❑__ <br />MWCC SAC Charge <br />�eN <br />On Site Septic System <br />Fee <br />ACKNOWLEDGEMENT <br />CITY PERMIT NO. 8178 <br />Date <br />Address v I <br />Address <br />state License No, <br />❑ ADDITION <br />❑ REPAIR <br />S — <br />Water Well <br />Fee <br />S <br />S ___ <br />Mechanical F•quipment <br />Fee <br />S <br />Moving /Lifting BuildingF <br />Fee <br />S <br />S _ <br />Land Alteration (Excavation, <br />Fee <br />S <br />Grading, Filling, etc.) <br />S — <br />Fire <br />I-ee <br />S <br />Sprinkler System (Fire) <br />Fee <br />S <br />S <br />Other: <br />Fee <br />S <br />S '� <br />After -the -fact Investigation <br />Fee <br />S <br />The undersigned herel., acknowledges receipt of this limited <br />permit, including aeee, of all special Information, <br />terms, conditions or _rements written above. The <br />undersigned understanew .nd agrees under penalty of law <br />that this permit is suictly limited in scope to the work, <br />activity or improvement specified; that Oils permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals; and that this permit does not <br />grant authority to violate env provision of any City <br />ordinance or State law, rule or ._gulation. All work shall be <br />done In strict compliance with all City ordinan,es, buuding <br />codes and/or health department regulations, and shall be <br />subject to Inspect' ,n, approval or reJection t•v the City. <br />Whsne.er to ordered, the undersigned agree, to correct <br />any work found to be irviolation of the conditions of <br />thi- permit <br />Sig <br />Cirt:f Applicant <br />- <br />TOTAL <br />State Surcharge: <br />Fee S <br />Total Amount Paid to City Fee SS� <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. I <br />Signature,pf City <br />Code. White A de Copy Csnary Inspector's Copy Pink—Finan-c Copy <br />-Applicant's P •-eipt <br />