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jlNERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />Owner yO-. __________________ <br />CITY PERMIT NO. 8254 <br />Date. <br />Contractor. <br />Address. <br />Address. <br />/.^9^ Afhn, ^y. <br />City License No..State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (#fixtures —) <br />Water Meter (Size__) <br />Meter#_____________ <br />□ NEW □ ADDITION □ REPAIR <br />Remote <br />Municipal Water Connection <br />Jopper <br />Municipal Sewer Connection <br />□ pVC DCast Q. <br />MWee SAC Charge <br />On Site Septic System <br />Fee S <br />Fim. s: <br />Water Well Fee <br />Mechanical Equipment Fee <br />Moving /Lifting Buildings Fee <br />Land Alteration (Excavation, Fee <br />Grading, Filling, etc.) <br />Fire. Feec <br />Sprinkler System (Fire) Fee <br />Other: Fee <br />After-the-fact Investigation FeeFee S <br />ACKNOWLEDGEMENT <br />The undersigned hereby kcknowledges receipt of this limited <br />permit, including ecccpUnce of eU 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 actlWties requiring <br />separate permit approvals; and that this permit does not <br />grant authority to violate any prodsion of any City <br />ordinance or SUtc law, rtUe or regulation. All work shall be <br />done 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 vIoUtlon of the conditions of <br />this permit. <br />Signature of Applicant <br />__AAa ^ <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S <br />Fee <br />This pennit 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 />Code: Wliltc-Illc Copy Canar>'-lnspcc<:or*5 Copy Pink-Financc Copy Gold-Applicant's Receipt