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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.8142 <br />Date <br />Address <br />Contractor <br />City License No. <br />Address /^^ViLK <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />________^ ~/C>VO ^ /r>^X. <br />PERMIT TYPE AND FEE: <br />Inside Plumbing (#fixtures __) <br />Water Meter (Size__) <br />Meter#_____________ <br />ja^JEW □ ADDITION □ REPAIR <br />Remote #, <br />Municipal Water Connection <br />DCopper n <br />Municipal Sewer Connection <br />□ PVC □ Cast Q <br />MWee SAC Charge <br />On Site Septic System <br />Fee S 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 />Fpp $ <br />» <br />Fee S <br />Fee $ <br />Sprinkler System (Fire) Fee <br />Other: Fee <br />After-the-fact Investigation FeeFe. <br />ACKNOWLEDGEM ENT <br />Tht undtiilgMd bmby acbnowltdctt ractlpt of tbit limtud <br />pofBiil, bMludbif occopUnc# of aO ipoeUl bifotmatfoii, <br />toms, condltfonB or itquiftmtnU wditon abova. Tb# <br />umiafdfiiad luidaratandi and agraaa undar panalty of law <br />that fbla paimlt U ttrictiy Umitad In tcopa to lb# work, <br />activity or lmprov#m#nl ip#ctfl#d; tiiat Ibla patmlt doaa <br />nol grant any authority to do work or aetivltlaB raqulitnf <br />aaparat# permit approval#; and that tbia permit doe# not <br />ipant autiiorfty to violate any provltion of any City <br />ordinance or Stale taw, rule or regulattooi. AD work abaD be <br />done bi atiict comptianee nrltb aD City ordtaianeaa, buildini <br />eodea and/or bealtb dapartinent ragulationa, and diaO be <br />aubiect to Inapeetion, approval or lafectton by tbe City. <br />Wbebever to ordered, the undeialined agiaea to correct <br />any work found to be In violation of tbe condlttona of <br />Ibla permit. <br />Signature of Applicant <br />Fee s <br />Fee <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />This permit is not valid until the proper fee is paid and < <br />it is approved by an authorized City Official. <br />iignatu^^^ty^^c^ <br />Code tirhilc I lie Copy (anary - Inipector't Copy Fiftk-Hiiafica Copy Goid-AppikanCf Racaipi