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GENERAL PERMIT CITYPERMITNO. 82�� ' <br /> CITY OF ORONO Date ��d. � � <br /> P.O.BOX 66 <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612)473-7357 <br /> .�t , <br /> Owner � 1��j�� ������ Address �`- i'� f`- �� . <br /> Contractor Address <br /> City License No. State License No. <br /> REMARKS AND SPECIAL CONDITIONS <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 /> � Grading, Filling, etc.) <br /> ❑Copper <br /> Municipal Sewer Connection Fee $ _ <br /> Fire Fee $ <br /> ❑ PVC ❑Cast ❑ Sprinkler System (Fire) Fee $ <br /> MWCC SAC Charge Fee $ ��� Other: Fee $ <br /> On Site Septic System Fee $ After-the-fact Investigation Fee $ <br /> ACKNOWLEDGEMENT TOTAL <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 a�ees under penalty of law State Surcharge: Fee $ <br /> that this permit is stricUy limited in scope to the work, <br /> activity or unprovement specified; that this permit does � ;� <br /> not grant any authority to do work or activities requiring Total Amount Paid to City Fee �2� —�� � <br /> sepazate permit apProvals; 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 ordinances, building <br /> codes �aior health department regulations, �a sh8u be This permit is not valid until the proper fee is paid and <br /> subiect to inspection, apProval or reiection by the c�tY. it is approved by an authorized City Official. <br /> Whenever so ordered, the undersigned agrees to conect <br /> any work found to violation of the conditions of <br /> this perm' . <br /> Si afure of A ' an Signature of City Official <br /> �u� �`'�,'�- /Z-3n_f?'� � �/ <br /> Code:White—FIle Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />