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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 &AoV I Ur I <br />F,-, r—,T— — <br />Contractor �3 <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE. AND FEE: *NEW ❑ ADDITION <br />Inside Plumbing ( # fixtures ) <br />Water Meter (Size ) <br />Meter # _ <br />Remote # <br />Fee S <br />Fee S <br />Municipal Water Connection Fee S <br />❑ Copper rl <br />Municipal Sewer Connection Fee S <br />❑ PVC' ❑ Cast <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee S _ <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all special information• <br />terias, conditions or requirements written above. The <br />undersigned 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 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 any provision of any City <br />ordinance or State law, rule or regulation. All work shall 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 agrees to correct <br />any work found to be in violation of the conditions of <br />this permit. <br />Signature of Applican� <br />CITY PERMIT NO. 706 I <br />Date T,3 <br />Address / J <br />!E� 4j',ke_� <br />Address <br />State License No, <br />❑ REPAIR <br />On Site Septic System Fee S �,, <br />Water Well Fee S ao. o0 <br />Mechanical Equipment Fee S <br />Moving/Lifting Buildings Fee S <br />Land Alteration (Excavation, Fee S <br />Grading, Filling, etc.) <br />Other:_ Fee S <br />After -the -fact Investigation Fee S <br />DOTAL <br />State Surcharge: Fee S <br />Total Amount Paid to City Fee S e• S <br />This permit is ;lot valid until the proper tcc is paid and <br />it is approved by an authorized City Official. <br />Sig ! of( Its Official <br />Code White File Copy ('anarf hupech,r's ('opy Pink I finance Cop) Gold Applicant's Receipt <br />