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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 4-73-7357 <br />CITY PERMIT NO. 7786 <br />Date / /O e 'r I <br />Owner ry K19,111, <br />P }7 n / Address e,:>eD(7) CL. 2 i/� Pam) �✓ - <br />Contractor IQ"Z C�.��n7� � �l i Address � `� %�Qj;;�. L L)Ofn <br />City License No. 7 L State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_) <br />Water Meter (Size—) <br />M^ter# <br />Remote # <br />4ANEW ❑ ADDITION <br />Fee S <br />Fee S <br />Municipal Water Conm_ction Fee S <br />❑Copper II <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast CI <br />MWCC SAC Charge Fee S <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />❑ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire <br />Sprinkler System (Fire) <br />- Uther: <br />Fee S lAfter-the-fact Investigation <br />The undersigned hereby acknowledges receipt of this limited <br />permit, including acceptance of all special information, <br />&arms, conditions or requirements written ar 1. 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 speclfled: 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 snall 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 to ordered, the undersigned agrees to correct <br />any wore found to b- in violation of the conditions of <br />this permit. <br />Signature of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S - :11 WJ <br />Fee <br />S _ <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee <br />S <br />Fee S ' -Sol <br />Fee 53o'J6 <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 of City Official <br />Code. Mite -File Copy Canary inspector's Copy <br />Pink - F inance Copy <br />Gold —Applicant's Receipt <br />