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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(6 12) 473-735 <br />Owner <br />Contras <br />City Li <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE: "71!iNEW <br />Inside Plumbing (#fixtures_) Fee S <br />Water Meter (Size—) Fee S <br />Meter# <br />Remote -1 <br />CITY PERMIT NO. 8154 <br />Date / U - k3U' <br />Address c� <br />Address RE 1 /;nX17Sr JCa�, <br />Mate License No, <br />❑ ADDITION ❑ REPAIR <br />Municipal Water Connection Fee S <br />❑Copper ❑ <br />Municipal Sewer Connection Fee S _--- . <br />❑ PVC ❑ Cast r- <br />MWCC SAC Charge Fee S <br />On Site Septic System Fee S <br />ACKNOWLEDGEMENT <br />The undersigned hereby acknowledges receipt of thle limited <br />permit. Including acceptance of as 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 limited in scope to We work. <br />activity or improvement spsalfled: that this permit does <br />not grant any authority to do work or activities rotuldne <br />separate permit approvals; and that " penult does not <br />grant authority to violate any provision of my City <br />ordinance or State law, rule or regulation. All work shall be <br />done In strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shell be <br />subject to Inspection, approval or rejection by elle 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 of Applicant <br />i6u4i,•_ AL, <br />Water Well <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fee S O' Q <br />Fee S <br />Fee S <br />Fee S— <br />ire <br />Fee <br />S <br />.)rinkler System (Fire) <br />Fee <br />S <br />ther: <br />Fee <br />S <br />fter-the-fact Investigation <br />Fee <br />S <br />TOTAL <br />State Surcharge: Fee S <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 />Signatur City <br />Code: White - File Copy Canary --Inspector's Copy Pink—Finance Copy Gold—AppUcagt's Receipt <br />