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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 />CITY PERMIT NO.8472 <br />Date. <br />f\rl^/v<LOwner. <br />Con tniPtnr <br />City License No-------------1^1 <br />pf>e^ <br />) pimb. <br />Address. <br />Address. <br />State License No.. <br />REMARKS AND SPECIAL CONDITIONS <br />S' # S3S<^ <br />PERMIT TYPE AND FEE: □ NEW □ ADDITION <br />Inside Plumbing (^fixtures ) Fee S------------ <br />) Fee S------------Water Meter (Si?.e <br />Meter#___ <br />Remote #. <br />Municipal Water Connection Fee S. <br />ropper <br />Municipal Sewer Connection <br />E^PVC DCast Q. <br />MWee SAC Charge <br />On Site Septic System <br />Fee S 36.cyD <br />□ REPAIR <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire____________________ <br />Fee S. <br />Fee S. <br />Sprinkler System (Fire) <br />Other:_____________ <br />After-the-fact Investigation <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S <br />Fee S. <br />ACKNOWLEDGEMENT <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 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 does not <br />grant authority to viotaU any provision of any City <br />ordinance or State law, rule or regulation. All work shall be <br />dune In strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subject 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 ApplicantSignature of i <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S_L. <br />^30.<h <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 />Cctlc: Wiltc-MIc Copy Canaiy-lnspcctor’i Copy Pink-I'lnanec Copy Gold-Applicant's Receipt