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GENERAL PERMIT <br />CITY OF ORONO <br />Owner <br />P.O. BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(61 2) 473-7357 <br />Contractor�`'� - ) <br />City License No. <br />REMARKS AND SPECIAL CONDITIONS <br />Address <br />//Address <br />PERMIT TYPE AND FEF: ❑ NEW ❑ ADDITION <br />Inside Plumbing (#fixtures ) <br />Water Meter (Size ) <br />Meter# <br />Remote <br />I-ee S <br />Fee $ -- <br />Municipal Water Connection Fee S _ <br />❑ Copper n <br />Municipal Sewer Connection Fee S _ <br />0 PVC ❑ Cast <br />MWCC SAC Charge Fee S . <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />CITY PERMIT NO. 7893. <br />Date _I-- / ?�;_ <br />State License No. _ I <br />0REPAIR <br />:iter Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration ( Excavation, <br />Grading. Filling, etc.) <br />Fee S <br />Fee S <br />Fee $ <br />Fee S <br />Fire Fee S <br />Sprinkler System (Fire) <br />ther: <br />I'r'e g After -the -fact Investigation <br />The undersigned hereby acknowledges receipt of this Waited <br />permit. including acceptance of all pedal information. <br />terms. conditions or requirements wdtten above. The <br />undersisned 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 this permit does not <br />grant ruthority to violate any provision of any City <br />ordinance or State law. rule or regulation. All wota @hall be <br />done M strict compliance with all City ordinances, building <br />codes and/or health department regulations. and shall be <br />sublect to impoedon. approval or relecticn 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 %N w^^'�••""� <br />TOTAL <br />State Surcharge - <br />Fee S <br />Fee S <br />Fee S <br />Fee S -5-0 <br />Total Amount Paid to City Fee ' <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signatore of city Ofjfici <br />Cad White t i e Copy Canary In"- vir's Copy Pink F inance Copy Gold - Applicant's Rpt <br />