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GENERAL PERMIT CITYPERMITNO. g46� � <br /> CITY OF ORONO <br /> P.O.BOX 66 Date <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612) 473-7357 <br /> Owner �• �'1 I�L-f�Address .� �`—� ������ � ��• <br /> Contractor��d rn v TC1'S • Address �1" �CJG�� /�/" <br /> City License No. � v T State License No. <br /> REMARKS AND SPECIAL CONDITIONS <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br /> Inside Plumbing (#fixtures_) Fee $ Water Well Fee $ <br /> Water Meter (Size_) Fee � Mechanical Equipment Fee $ <br /> Meter# <br /> Remote# Moving /Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ �� •�_ Land Alteration (Excavation, Fee $ <br /> � Grading, Filling, etc.) <br /> �Copper <br /> Municipal Sewer Connection Fee $ _ <br /> Fire Fee $ <br /> ❑ PVC ❑Cast Q Sprinkler System (Fire) Fee $ <br /> MWCC SAC Charge Fee $ Other: Fee $ <br /> On Site Septic System Fee $ After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <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 a�ees under penalty of law State Surcharge: Fee � <br /> that this permit is strictly limited in scope to the work, <br /> activity or irnprovement specified; that this permit does � (-7l <br /> not grant any authority to do work or activities xequiring Total Amount Paid to City Fee $ u�� <br /> sepazate Permit approvals; and that this permit does not <br /> grant authority to violate any provision of any City <br /> oxdinance or State law,rule or regulation. All work shall be <br /> done in strict compliance with all City ordinances, building <br /> codes �a�or ne�cn department regulations, �,a sh8u ue This permit is not valid until the proper fee is paid and <br /> subiect to inspection, approval or reiection by the c�tv. it is approved by an authorized City Official. <br /> Whenever so ordered, the undersigned agrees to conect <br /> any work found to be in violation of the conditions of <br /> this permit. <br /> Signature of Applicant ` Signature of City Official <br /> � <br /> �� / , <br /> 1��:,������'zl�- ��(.%� <.✓,� <br /> Code:White—FIIe Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanYs Receipt <br />