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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 />Owner ^ <br />CITY PERMIT NO.7763 <br />Contractor. <br />City License No.. <br />Address S^O .^h)/ Acj-hr>n U3<X^ <br />Address /L>1 cV 7<o/ <br />State License No---------------------------------------------------- <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: □ NEW □ ADDITION □ REPAIR <br />Inside Plumbing (#fixtures —) <br />Water Meter (Size__) <br />Meter#_______ <br />Remote #. <br />Municipal Water Connection <br />n Copper Q___ <br />Municipal Sewer Connection <br />□ pVC DCast □. <br />MWee SAC Charge <br />On Site Septic System <br />Fee S <br />F(»P 5; <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 />F pp S_____ <br />Fee S <br />Fee 5; _ _ <br />Sprinkler System (Fire) Fee <br />Other: Fee <br />After-the-fact Investigation FeeFee 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 />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 tUs permit docs not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule 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 violation of the conditions of <br />this permit <br />Signature of AppliMnt ^ <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S__ <br />Fee <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 />(7 <br />CodcMVliitc-File Copy Canary-Inspector ’s Copy Pink-Finance Copy Gold-AppUcant ’s Receipt