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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO.8113 <br />Owner <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />L612) 473-7^7 , <br />Date <br />Contractor I tT"i(Ck ^ (X <br />Address <br />Address <br />City License No.^ i V <br />I 'T^OL l+,j <br />State License No.___________ <br />7 m+licx_ <br />* t <br />• L <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: □ NEW □ ADDITION □ REPAIR <br />Inside Plumbing t#fixtures__) <br />Water Meter (Size <br />Meter#___ <br />.) <br />Fee S <br />Fee S <br />Remote #. <br />Municipal Water Connection <br />DCopper rn <br />Fee $ <br />Municipal Sewer Connection <br />□ PVC □ Cast Q <br />MWee SAC Charge <br />On Site Septic System <br />Fee S- <br />Fee $ <br />Fee S. <br />Water Well Fee $,^o ct> <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />CJrading. Filling, etc.) <br />Fee S <br />Fee S <br />Fee S. <br />Fire <br />Sprinkler System (Fire) <br />Other:____________ <br />Fee $ <br />Fee S <br />After-the-fact Investigation <br />Fee $ <br />Fee S <br />ACKNOWLEDGEMENT <br />Th« un4»nlfiicd hmby BcluiawtoddM rmipi of tfUt liaillod <br />poffmlt. lAchidtaig occoptanco of oD m^ei9X tefomolkMi, <br />toniit, condltfont or loquiiwaiMiU wditon obovo. tile <br />underMfoed luideretafidi and epees under penalty of law <br />tiMt this permit U stiteliy limlled in seope to the woth, <br />activity or Improvement pecifled; that this permit dnae <br />not pant any authority to do work or activities requislni <br />separate permit approvals: and that this permit does not <br />pant aulhoiily to violate any poviston of any City <br />ordinanoe or Stale law, rule or repUation. AU work diall he <br />done In sMet compUance with all City ordlnaneee. buUdlnf <br />codas and/or haaHh department repUattons. and diaS he <br />iohlaet to hMpecllon. approval or leiecilon hy the City. <br />Whenever so ordarad, the undendpmd ^lees to correct <br />any work found to he In violation of the conditions of <br />this paonit. <br />Signature of Aorlicant <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />F« . <br />Fm S O ^ <br />This permit is not valid until tfie proper fee ia paid andl <br />it is approved by an authorized City Official. <br />latur^,^ (Signatur^^fT City Offief <br />wniif . rat Copy Cahify Inipcctar's Copy Phik-nnanca Copy Iff