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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 Zof Qe#6� <br />Contractor / <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />CITY PERMIT NO. 67851 <br />Date t�7 -3b -0� <br />Address <br />Address 1Z W 6 G.• . <br />itate License No. <br />PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br />Inside Plumbing ( # fixtures ) Fee $ _ <br />Water Meter (Size ) Fee $ -- <br />Meter # _ <br />Remote # <br />Municipal Water Connection Fee $ <br />❑ Copper ❑ <br />Municipal Sewer C, nnection Fee $ <br />❑ PVC ❑ Cast ❑- <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee $ <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 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 no: <br />grant authority to violate any provision of any City <br />ordinance or State law, rule o. regulation. All work &hall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and &hall 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 />Siyur � of Ap 'ant <br />On Site Septic System Fee S <br />Water Well Fee S <br />Mech.,nical Equipment Fee $ <br />Mop ing/Lifting Buildings Fee $ <br />Land Alteiation (Excavation, Fee $ <br />Grading, Filling, etc.) <br />Other: <br />Fee $ <br />After -the -fact Investigation Fee $ <br />TOTAL <br />State Surchar ve: Fee $ <br />Total Amount Paid to City Fee S Ot4(2 <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sig lee of City Ic al <br />t 1 � — <br />Code. White -Idle Copy Canary- Inspector's Copy Pink -finance Coe; Gold --Applicant's Receipt <br />