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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO.8482 <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Date. <br />Owner.<f)ab !P)/7rnjT\^y 7.5.1/) f\rkx>H <br />r„—LeuU^r- lAJe.ll C.0 . <br />City Licanse No-------7^^^-------/ *7 7--------------- <br />Address <br />Address \// Cjfp/'mk) <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (^fixtures—) <br />^ NEW □ ADDITION □ REPAIR <br />Water Meter (Size—) <br />Meter#_______ <br />Fee S. <br />Fee S. <br />Remote #. <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Municipal Water Connection <br />d Copper Q____ <br />Fee S. <br />Municipal Sewer Connection <br />□ pVC dCast Q. <br />MWCC SAC Charge <br />Fee S <br />Fee S. <br />On Site Septic System Fee S. <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S <br />Fee S <br />Fee S. <br />Fee S. <br />Fire, <br />Sprinkler System (Fire) <br />Other:______________ <br />Fee S. <br />Fee S. <br />Fee S <br />After-the-fact Investigation Fee S. <br />ACKNOWLEDGEMENT <br />The undersiftnccl hereby acknowledges receipt of this limited <br />permit, including occeptance of all special Information, <br />terms, conditions or reaulrements written above. The <br />underdgned 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 docs not <br />grant autliority to violate any provision of any City <br />ordinance or State law, rule or regulation. All work shaU be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subiect 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 />Signature of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee $ ^____ <br />Fee S 30 <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 OffiejaH <br />7^ <br />Code: Wliltc-l-ilc Copy Canary-Inspector’s Copy Pink-Rnance Copy Gold-Applicant’s Receipt