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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNLSOTA 55333 <br />(612)473-7357 <br />CITY PI RMIT NO.7196 <br />Date lo-ll-fz <br />Owner__ <br />Contractor <br />A (612)473-7357 . <br />AWT aj ? (? . Ixll Adilress <br />Address <br />City License No.State License No. <br />Rf MARKS AND SN C lAL CONDITIONS <br />''j/plaao <br />PT.RMIT TYPI ANDFLF: <br />Inside Plumbing ( # fixtures <br />Water Meter (Si/e____) <br />Meter #___________ <br />(OsNFw □addition Grfpair <br />Foe S, <br />Fee S. <br />Remote# <br />Municipal Water Connection <br />□ Copper n <br />Fee S. <br />Municipal Sewer Connecti«)ii <br />□ PVC □ Cast Q <br />Fee S. <br />MWee SA(' Cliarge Fee S. <br />On Site Septic System <br />Water Well <br />Mechanical Lqiiipnient <br />Moving/Lifting Buildings <br />Land Alteration (Fxcavation, <br />Grading, Filling, etc.) <br />Other:___________________ <br />After-the-fact Investigation <br />I ee S <br />I’ce S <br />lee ^ (^6. <br />Fee $ <br />Fee S <br />Fee S. <br />Fee S <br />ACKNOWLEDGEMENT <br />The under»gned hereby si knotAledges receipt of this UmiUd <br />permit, including arcepUme of tJ] special infurmation, <br />terms, < «>ndiUuns or requlrcmenOi urilten sb«ive. The <br />undersigned understands snd Agrees under penidtv of Uw <br />that this permit is strlcUv Umiied in scope to the work, <br />tetUitv or improvement specified, that this permit does <br />not gr«nt any authonty to do work or activities requiring <br />separate permit approxals. and that this permit does not <br />grant authority to violate 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 ordlnancea. building <br />codes and/or health department regulations, and shall be <br />subject to Inspection, approval or refection 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 />itunh.Signatij^rc ol Applicant <br />TOTAL <br />State Surcharge <br />Total .Amount Paiil to City <br />Fee S <br />Fee <br />This permit is not valid until the proper fee is paid and <br />it is approved b> an authorized City OfTicial. <br />( ixk ^liitc t ile ( upy Canary m ir *s Copy Hnii; I inante Copy (■ dd* Applkant^ Receipt