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GENERAL PERMIT CITYPERMITNO. 8230 � <br /> CITY OF ORONO Date i � �� <br /> P.O.BOX 66 <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612)473-7357 <br /> Owner 1 �Sn� Address 't�� �� �rZ%l <br /> Contractor I�/�r�J�� _ �� [�'�-�G�1 �L%ISCf/�A�dress`� /,�� .���'�t Crfvl ��-`�C> ��• <br /> City License No.�_�n r�'�� r°�1 C- State License No. ��� <br /> REMARKS AND SPECIAL CONDITIONS <br /> � <br /> � T r .� ` �t � C'�°?� i G'�V o� C C c� r <br /> �-al f'I')Gt �,�i� I'��1 -�1�'C���'�� <br /> PERMIT TYPE AND FEE: �J 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 n 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 S� <br /> undexsigned 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 improvement specified; that this permit does � _,� <br /> not grant any authority to do work or activities requiring Total Amount Paid to City Fee $ <br /> sepazate permit approvals; and that this permit does 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 ordinances, building <br /> codes �a�or health department regulations, �a snau be This permit is not valid until the proper fee is paid and <br /> subiect to inspection, approval or reiection by the c�cY. 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 /> Signatu �Ap ant Signature of City Of�cial <br /> ` �� , <br /> __ ow ���9� <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />