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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 G 0.X A l 1Z M c M 1 // D_n <br />Contractor Sa Il 1 da.r,_ <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: ❑ NEW <br />Inside Plumbing ( # fixtures ) <br />Water Meter (Size ) <br />Meter # <br />Remote # <br />❑ ADDITION <br />Fee $ <br />Fee $ <br />Municipal Water Connection Fee $ <br />❑Copper ❑ <br />Municipal Sewer Connection Fee $ <br />❑ PVC ❑ Cast El <br />MWCC SAC Charge <br />ACKNOWLEDGEMEN'l <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 tbls permit is strictly limited in scope to the work, <br />activity or improvement specifted; 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 />Brant 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 1pspectlon, approval or rejection by the City. <br />Wbanever so ordered, the undersigned agrees to correct <br />any work found to be in violation of the conditions of <br />ibis permit. <br />CITY PERMIT NO. 6825, <br />Date a 4 - -a- <br />Address !6 a Q /W \i/r`,F1, ' <br />Address '-� ` /D 0 '." /079-t <br />State License No. <br />:EPAI R <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Other: <br />After -the -fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee <br />$ 60 <br />Fee <br />$ <br />Fee <br />$ <br />Fee <br />$ — <br />Fee <br />Fee <br />g <br />Fee <br />$ <br />Fee I I S'0 <br />Fee $ Ad- S'o <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 - file Copy Canary --Inspector's Copy Pink- Finance Copy Gold Applicant's Receipt <br />