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CITY PERMIT NO. " 6826 ' <br />Date — <br />GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />Owner Address ^ <br />Contractor______AJ.S'T*/ Address f<J <br />City License No..State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />(VIaaJP. Fi/lep//ia <br />PERMIT TYPE AND FEE: <br />Inside Plumbing { § fixtures. <br />Water Meter (Size___) <br />Meter if__________ <br />□ NEW <br />_) <br />DDITION □ REPAIR <br />Fee S_ <br />Fee S. <br />Remote H <br />Municipal Water Connection <br />D Copper n---- <br />Fee S. <br />Municipal Sewer Connection <br />□ PVC □ Cast HL <br />Fee S. <br />MWee SAC Charge Fee S. <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <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 />ACKNOWLEDGEMENT <br />Tlie undenisned hereby acknowledges receipt of this limited <br />permit, Including acceptance of all special Information, <br />terms, conditions or requIremenU written above. The <br />undersigned undersUnds and agrees under penalty of law <br />that this permit Is strictly limited In *icope to the work, <br />activity or improvement speclfled: that this permit does <br />not grant any authority to do work or activities requiring <br />separate permit approvals; and that this pennit does not <br />grant authority to \iolate any provision of any City <br />ordinance or State law, rule or regulation. AU work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />lublect 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 />/ <br />TOTAL <br />State Surcliarge: <br />Total Amount Paid to City <br />Fee <br />Fee S______ <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Sienatiim nffitv OfficiaL ^ ^ <br />Code: \Vlilie-nic Copy Omary-Inspector’s Copy Pink-Mnance Copy Gold-Applicant’s Receipt