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GENERAL PERMIT CTTY PERMTT No s s o� <br /> CITY OF ORONO <br /> P.O.BOX 66 Date �� � r /� � <br /> � <br /> CRYSTAL BAY,MINNESOTA 55323 <br /> 612)473-7357 <br /> Owner ' � � Address �� � �� <br /> Contractor Address <br /> City License No. City � <br /> REMARKS AND SPECIAL CONDITIONS . <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDTITON ❑ REPAIR ❑ REMODEL <br /> Inside Plumbing(#fixtures ) Fee $ Water Well Fee $ <br /> Water Meter(Size ) Fee $ Mecha.nical Equipment Fee $ <br /> Meter# Fireplace/Wood Stove Fee $ <br /> Remote# Moving/Lifting Bu�dings Fee $ <br /> Municipal Water Connection Fee $ Iand Alteration(F�ccavation, <br /> ❑ Copper ❑ Grading,F�71ing,etc.) Fee $ <br /> Design Review Fee $ <br /> Municipa�Sewer Connection F� $ Fire Fee $ <br /> ❑ PVC ❑ Cast ❑ � <br /> MWCC SAC Charge Fee $ � Sprinkler System(Fire) Fee $ <br /> Other. Fee $ <br /> On Site Spetic System Fee $ <br /> After-the-fact Investigation Fee $ <br />, <br /> ACKNOWLEDGEMENT TOTAL <br /> , State Surcharge: Fee $ <br /> 'fhe undersigned hereby acknowl� receipt of this limited pemut, ��1 <br /> 1 <br /> including accephance of all special information, ternu, conditions or Total Amount Paid to City FP� $ � � <br /> , requirements written above. The undersigned undersmnds and agrees <br /> under penalty of law that this permit is strictly limited in scope to the work, <br /> activity or improvement specified;that this permit dces not grant any <br /> authority to do work or activities requiring separate permit approvals;and <br /> that this permit dces notgrant authority to violate any provision of any Ciry <br /> ordimnce or State law,nile or regulaaon.All work shall be done in strict '�permit is not valid until the proper fee is paid and it is approved <br /> compliance with all City ordinanc�s, bmlding codes and/or health b an authorized Ci ��Cl�. <br /> department reguladons,and shall be subject to inspeclion,approval or y �' <br /> rejection by the Ciry.Whenever so ordered,the undersigned agrees to <br /> correct any work found to be in vialadon of the conditions of this permit. <br /> 'e of Applicant <br /> Signature of City Off ' <br /> a <br /> Code: White—File Copy Canary—lnspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />