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:NERAL PERMIT CITY PERMIT No. _70401 <br />PITY OF ORONO <br />P.O.BOX 66 Date <br />CRYSTAL BA:', MINNESOTA 55323 <br />(61-I) A73-7357 <br />If 107 1.1111 <br />Adders <br />SS <br />actor Address <br />License No. _ State License No. , <br />MARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEF.: <br />Inside Plumbing ( # fixtures <br />Water Meter (Size ) <br />Meter # <br />Remote # <br />❑ AUDITION ❑REPAIR <br />Fee $ <br />Fee S <br />Municipal Water Connection Fee S <br />❑Copper <br />Municipal Sewer Connection Fee $ _ <br />❑ PVC ❑ Cast n — <br />MWCC SAC Charge <br />ACKNOWLEDGEMENT <br />Fee S <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 />undersigned understands and agrees under penalty of law <br />that this permit is strictly tlmtited 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 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 W City ordinances, building <br />codes andlor 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 %iolation of the conditions of <br />/bis permit. <br />Signature of Applicant <br />. 6�4= <br />On Site Septic System <br />Water Well <br />Mechanical Equipment <br />Moving/Lifting Buildings <br />Land Alteration (Excalation, <br />Grading, Filling, etc.) <br />Fee S �A <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Other: Fee S <br />After -the -tact Investigation Fee S <br />TOTAL <br />Stats' Surcharge Fee S <br />Total Amount Paid to City Fee S <br />This pennit is not valid until the proper tee is paid and <br />it is approved by an authorized City Official. <br />'d, <br />Code While I ile Copy Canary Inspector's Copy fink I inance Copy Gold Applicant's Receipt <br />IN <br />1 <br />