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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.8527 <br />Date pi <br />Owner, <br />% <br />Address C <br />City License Nn. _______ State License No. <br />M:>iovdi>sj ia Jcu ^ <br />. - V ! <br />REMARKS AND SPECIAL CONDITIONS <br />^ ^C\jJj/S^Z> 3.^ <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (^fixtures__) <br />Water Meter (Size__) <br />Meter#_____________ <br />D^W □ ADDITION □ REPAIR <br />Remote #. <br />Municipal Water Connection <br />.-opper <br />Municipal Sewer Connection <br />□ pVC DCast Q. <br />MWCC SAC Charge <br />On Site Septic System <br />Fee S <br />Fee 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 Fee <br />Fee Si <br />Car, cree o <br />Fee S <br />Sprinkler System (Fire) Fee <br />Other: ^ Fee <br />After-the-fact Investigation FeeFee S ^S.07^ <br />ACKNOWLEDGEMENT <br />The undenifiitd hcteby ackaowlediee ftceipt of this limited <br />peimil, locluding eeceptence of ell iPMiel faifoimetloii. <br />teimi, condltioiu or lequiiemeiiti wdtten above. The <br />uadenigaed UBdentendi end agrees under penalty of law <br />that this permit Is strictly limited in scope to the wocfc, <br />activity or impiovcment ipecifledi that this pennit 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 violate any provMoa of any City <br />ordinance or State taw, rule or regulation. All work draD be <br />done In strict compiiance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subiect to inspection, approval or relcction by the City. <br />Whenever so ordered, tiie underslvied agrees to correct <br />any work found to be In violation of the conditioiu of <br />this permit <br />Signature of Applicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee » <br />Fee $.Z5L^?. <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 Offipwl <br />( / C _ <br />Code: White-File Copy Canary-Inspector's Copy Pink-Finance Copy Gdd-i^>plictnt*i RcMpt