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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />i 0 <br />CITY PERMIT NO. 8203 <br />Owner. <br />Pnntnirtnr [/^A <br />Address. <br />Address. <br />City License No.. <br />/^hinnr^r^'\ /Ah / <br />Q xa fc _____ <br />State License No.. <br />REMARKS AND SPECIAL CONDITIONS <br />^^ \_/ <br />^-hVl.no A<7^rVo ^4-1 <br />I—J T- 1 kf <br />/nr'J? t " <br />J f-------------------^ <br />yi f yirjui <br />PERMIT TYPE AND FEE: <br />jno y\ <br />□ ADDITION <br />/ ---------------------------------------------- <br />□ REPAIR <br />Inside Pkinibing (Ifixtures__) <br />Water Meter (Size__) <br />Meter# _____________ <br />Remote #. <br />Municipal Water Connection <br />_opper <br />Municipal Sewer Connection <br />□ pVC DCast □. <br />MWee SAC Charge <br />On Site Septic System <br />Fee S. <br />Fee S. <br />Fee 3. <br />Fee S <br />Fee S. <br />Fee S. <br />WaUTWcll <br />Mechanical Equipment <br />Moving /Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc.) <br />Fire. <br />Sprinkler System (Fire) <br />Other:_____________ <br />After-the-fact Investigation <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />Fee S. <br />ACKNOWLEDGEMENT <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 limited in scope to the work, <br />activity or improvement specified; that this permit does <br />not grant any authority to do work or actiWtles requiring <br />separate permit approvals: and that this permit does not <br />grant authority to \iolate any provision of any 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 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 bo in xiolatlon of the conditions of <br />this permit. <br />i <br />; <br />Signature of Applicant - . <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Re <br />Fee %2S1SIL <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signati^ of City Official <br />i <br />Code: WTilte-Filc Copy Canary-Inspector’s Copy Pink-Finance Copy Gold-Applicant’s Receipt