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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(6 12) 473-7357 <br />Owner h CIW6 Address <br />CITY PERMIT NO. 8017 <br />Date _ V ^ 9 <br />Co :tray :or ,/ �" i -C t.;l z� ��e, �I( IL -LL Address S <br />City License No.Z State License No. <br />REMARKS AND SPECIAL CONDITIONS / <br />PERMIT TYPE AND FEE <br />Inside Plumbing Ofixtures_) <br />Water Meter (Size_) <br />Meter# <br />Remote <br />1�J NEW ❑ ADDITION REPAIR <br />\ Fee S lWater Well <br />Fee S - - --_ IMechanical Equipment <br />Municipal Water Connection Fee S <br />❑Copper n <br />Municipal Sewer Connection Fee S <br />❑ PVC ❑ Cast 0_ <br />MWCC SAC Charge Fee S _ _ <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />Fee v -r i <br />Fee S <br />Moving !Lifting Buildings <br />Fee <br />S <br />Land Alteration (Excavation, <br />Grading. Filling, etc.) <br />Fee <br />S <br />Fire <br />Fee <br />S <br />Sprinkler System (Fire) <br />Dthel`: <br />Fee <br />Fee <br />S <br />S / S <br />Fee S (After -the -fart Investigation Fee S <br />The undersigned hereby acknowledMs receipt of this limited <br />Permit. Including acceptance of all special Information, <br />terms, conditions or requirements wdtten above. The <br />undersigned understands and agrees under penalty of law <br />that this permit is stricuy 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 authority to violate asy provision of any City <br />ordinanceor State law, rule or regulation. Ali work shall be <br />done in strict compliance with all City ordinances, building <br />codes and/or 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 violation of the conditions of <br />this permit. <br />Signature of Applicann�tt <br />TOTAL <br />State Surcharge: Fee S - SZ) <br />Total Amount Paid to City Fee S 3---a oo <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signatu f City 7Offl(/,.fi <br />Code:White-FileCopy Canary --Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />