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GENERAL PERMIT CITYPERMITNO. -_ '735'� � <br /> CITY OF ORONO Date 3 -� � —�� <br /> P.O.BOX 66 <br /> CRYSTAL BAY,MINNESOTA 55323 <br /> (612)473-7357 <br /> .� � �.�,�� ��-� �t���y _ Ch�s� ��- <br /> Owner Address <br /> � �E-�.-'�'�� 4�t�� � Address �Vl!)L� �hNA tn.� SS�fd`7 <br /> Contractor �J <br /> City License No. State License No. <br /> RF?MARKS AND SPECIAL CONDITIONS <br /> �'!� -�-tj �y4 C �_��/ll��� �I � -�- �� i�� C�,v�r-T t��.r C� <br /> / - �t .����:, <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br /> Inside Plumbing( # fxtures ) Fee $ On Site Septic System Fee $ <br /> Water Meter(Size ) Fee $ Water Well Fee $ <br /> Meter # a� <br /> Mechanical Equipment Fee $ .��• <br /> Remote# <br /> Mtxnicipal Water Connection Fee $ Moving/Lifting Buildings Fee $ <br /> ❑Copper ❑ Land Alteration (Excavation, Fee $ <br /> Grading, Filling, etc.) <br /> Municipal Sewer Connection Fee $ <br /> ❑ PVC ❑ Cast ❑ Other:� ��f�- � �N Fee $ �� <br /> MWCC SAC Charge Fee $ After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> The under�gned hereby acknowledQes receipt of this limited <br /> yermit, including acceptence of ell special information, <br /> terms, conditions or requirements wHtten above. The �' ��a <br /> undersigned understands and a�ees under penalty of law State Surcharge: Fee $ <br /> that this permit is strictly limited in scope to the work, �s�, <br /> activity or improvement specified; that this permit does �� <br /> not grant eny authoritv to do work or activities requiring Total Amount Paid to City Fee $ � <br /> seDsrate permit aDProvals; and that this permit does not <br /> �^ant authority to violate eny 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 he�rn deDaztment regulations, �a �neu be This permit is not valid until the proper fee is paid and <br /> subiect to inspection, approvel or rejection by the c�ty. it is approved by an authorized City Official. <br /> Whenever so ordered, the undersigned agzees to correct <br /> any work found to be in violatlon of the conditions of <br /> this permit. <br /> Signature of Applicant Signature � � f�cial , <br /> ��1`(� � �� , <br /> Code:White—FIIe Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />