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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 />CITY PERMIT NO. 7664 <br />Date _1&L- - <br />Address Ay> U�E'E ST .+11 <br />Contractor tCMWk-A .5:f U—) Address _ 4tWAJ > <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />4 kh <br />State License No. <br />PERMIT TYPE AND FEE: 9NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing (#fixtures_) <br />Water Meter (Size _) <br />\later# <br />Remote # <br />Fi:e S Water Well <br />Fee S __ Mechanical Equipment <br />\1un:, i)tal Water Connection Fee S-- <br />❑( tipper ❑ <br />n0 <br />\tuni�iltal Sewer Connection Fee S _ <br />KI'V(. ❑Cast F_ <br />.\I\k'( C SAC Charge Fee S _ <br />On Site Septic System <br />V-K NOW LEDGEM ENT <br />ing /Lifting Buildings <br />Land Alteration (Excavation <br />Grading, Filling, etc.) <br />Fee $ 1 <br />Fee S 1 <br />Fee S <br />Fee S_._J <br />ire Fee $__I <br />nkler System (Fire) <br />her: <br />Fee S IAfter-the-fact Investigation <br />the undersigned hereby acknowledges receipt of this limited <br />Permit. including acceptance of all special information, <br />terms, conditions or requirements written above. The <br />undersigned understands and &vets under penalty of law <br />that this permit is strictly limited in scope to the work, <br />activity rr Improvement specified: that this permit does <br />nttt grant any authority to do work or activities requiring <br />separate permit approvals: and that this permit don 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 ordlnancea, building <br />codes and/or health department regulations, and shall be <br />subject to Inspection, approval or rejection by the City. <br />Whenever ■o ordered, the undersigned agrees to correct <br />Anv work found to be in siolation of the conditions of <br />this permit. <br />Si_,n.itufr,f Applicants <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ <br />Fee S _-_ J <br />Fee S <br />S Si <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of City Official <br />Code White I ile Cop) Canarn Inspector's ('op) Pink I inance Copy Gold Applicant's Receipt <br />