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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(61 2) 473-7357 <br />CITY PERMIT NO. 7079 1 <br />Date 7 — 2-0' — S <br />Owner- C' rT 2VAe!X1QtJ Adtlres 2y� Cowtm-Ville UR <br />Contractur 7�)iw.4fIF r—IRT�EAC Address —7/?� VNeAoNF IT , C'�F'l'12 <br />City License No. <br />REMARKS AND SPHCIAL CONDITIONS <br />State License No <br />v�rfl S ys-g - ) o x 6, 3 _ <br />,eC-1i1jp4j�) -!5gAC LntA.) 'TXaj'4'j COV -S <br />PERMIT TYPE AND FEE: X NEW ❑ ADDITION <br />Inside Plumbing ( # fixtures ) Fee S <br />Water Meter (Size ) Fee S <br />Meter # <br />Remotc # <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast n <br />MWCC SAC Charge <br />AC'KNOWL EDGEMENT <br />Fee S <br />The undersigned hereby acknowledges receipt of this limited <br />Vermit, including acceptance of all special information, <br />terms, conditions or requirements %diten al�,rvs. The <br />undernaned understands and agrees under penalty of law <br />that utas permit Is strictly limited in scope to the work, <br />activity or improvement specified: that this permit does <br />not grant any authority to Jl� werk or activities requiring <br />$Operate permit approvals. and rnat this permit does not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. Aa work shall be <br />done in strict compliance with as City ordinances, building <br />codes and/or health department regula ijns, and &hall be <br />subktct to inspection, approval or rekction by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />anywork found to be in violation of the conditions of <br />this permit. <br />Signof Applicant <br />, tit23ZI'L4 <br />❑ REPAIR <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Fee S <br />Fee S <br />Moving/Lifting Buildings Fee S <br />Land Alteration (Excavation, Fee S <br />Grading, Filling, etc.) <br />"Cerj.S c o0 <br />Other: Fee S 1-a�— <br />After-the-fact Investigation Fee S <br />TOTAL <br />Stats: Surcharge: FCC S 60 <br />SD <br />Total Amount Paid to City Fee S 6—n <br />This pennit is not valid until the proper fee k paid and <br />it is approved by an authorized City Official. <br />Signature of City Official <br />r <br />Code: White- file Copy Canary Inspector's Copy Pink I inancc Copy Gold Applicant's Receipt <br />