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GENERAL PERMIT CITYPERMITNO. � 8429 � <br /> CITY OF ORONO Date �-� � P�� <br /> P.O.BOX 66 <br /> CRYSTAL BAY,MINNESOTA 55323 <br /> (612)473-7357 <br /> Owner ��� Address _ ���� rl� __ � �� <br /> Contractor � • Address <br /> City License No. `�� State License No. <br /> REMARKS AND SPECIAL CONDITIONS <br /> � �� <br /> ���� <br /> PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑REPAIR <br /> Inside Plumbing(#fixtures_) Fee $ Water Well Fee $ <br /> Water Meter(Size) Fee $ Mechanical Equipment Fee $ <br /> Meter# <br /> Remote# Moving/Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $ <br /> ❑Copper ❑ Grading, Filling, etc.) <br /> Municip Sewer Connection Fee $ <br /> ,o, �� Fire Fee $ <br /> PVC ❑Cast n 6� Sprinkler System (Fire) Fee $ <br /> MWCC SAC Charge ��� Other: Fee $ <br /> On Site Septic System Fee $ After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <br /> The under�t�aed hereby acknowledgea receipt of thie limited <br /> permit, including acceptance oP all epedal informatioa, ��� <br /> terms, conditiona or requiiements w�dtten above. The State Surchar e• Fee $ • <br /> under�lgned undezatands and a�rees uader penaltq of law g • <br /> that this permit is atrtetly limited in �ope to the work, ` <br /> activitq or improvement sAeciPied; that this permit doea �A <br /> not gtant any authorlty to do wark or activitiea requiring Total Amount Paid to City Fee � 0-7�-� <br /> sepazate permit aPprovals; and that thfs permit does not � <br /> grant authozity to vlolate enY Pi'ovieton oP any CitY <br /> ordinance or State law,rule or xegulation.All work shell be <br /> done in strict compliance with aII City ordiaaaces,buiiding � <br /> codes and/or health departmeat regulaf3oae, and shall be This permit is not valid until the proper fee is paid and <br /> aub�ect to inapectioa. approval or xe9ection by the CitY. it is approved by an authorized City Official. <br /> Whenever so ordered. the underaigned e�eea to correct <br /> any work found to be in violatton oP the conditions of <br /> this Permi� <br /> Signature o Applicant Signature o City Off ial <br /> � � _ <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />