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GENERAL PERMIT CITY PERMIT NO. 8485 <br />CITY OF ORONO <br />Date 0 Re A,6 <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner + - Address '1-16 96 <br />Contractor Address % �� ✓ r <br />City License No. f Y7& State License No. `�� � —1 <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: NEW <br />Inside PlumbingOfixtures_) Fee S <br />Water Meter (Size _1 <br />Meter <br />Remote <br />Municlp• I Water Connection <br />&opper ❑ <br />Municip 1 Sewer Connection <br />(PV(' ❑ Cast <br />MWCC SAC Charge <br />Ott Site Septic: System <br />ACKNOWLEDGEMENT <br />❑ ADDITION ❑ REPAIR <br />Fee S -- - <br />_ ,Water Well <br />-- Mechanical Equipment <br />oving %Lifting Buildings <br />Fee S C, C� ,Land Alteration (Excavation <br />Grading, Filling. etc.) <br />I <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />$ <br />Fee S �(o `',Fire Fee S I <br />Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all special information, <br />terms, conditions or requirements wdtten above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is strictly limited in scope to the work, <br />aeUvity or improvement specified: that this permit does <br />not gent any authority to do work or activities requiring <br />separate permit approvals: and that this permit dote not <br />grant authority to violate any provision of any City <br />ordlnancr or State law, rule or regulation. Ali work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations. and *hall be <br />subiect to ktspeetlon, approval or refection by We City. <br />Whenever so ordered. We undersigned agrees to correct <br />any work found to be in %iolation of the conditions of <br />this permit. <br />Signature o -40icant <br />i /• , �ji, �/.tr � <br />rinkler System (Fire) <br />- - (Other: <br />r-the-fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee S 1 <br />Fee S 1 <br />Fee S ' <br />Fee S <br />This permit is not valid until the proper fee is paid and I <br />it is approved by an authorized City Official. <br />Signature ojcity Official <br />( ode White I lie copy Canar) Inspector's Cop) Pink I inane t opy {send Applicant's Receipt <br />