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GENERAL PERMIT CITYPERMITNO. ��HH <br /> CITY OF ORONO <br /> P.O.EOX 66 Date '� � � <br /> CRYSTAL BAY, MINNESOTA 55323 <br /> (612)473-7357 <br /> Owner �. L—��?� f�����'�`� Address ��� ,,, ��c.k'7�� /��7�� /�� <br /> Contractor .�� '�' ��• (J`�� ���-���'�_ Address 7 ��% �)��/. ��f1 c� �C:��`i'�� /q-, l . <br /> City License No.�,� �/ /'1 ��' State License No. <br /> REMARKS AND SPECIAL CONDITIONS <br /> �-�-�2 � __ �s l�-�(�D �Ca7�r��� C�s �; ��� .�� 2. <br /> F�iC �� ��� . P �`'��`1-�' <br /> PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR <br /> Inside Plumbing (#fixtures_) Fee $ Water Well Fee $ <br /> Water Meter (Size_) Fee � Mechanical Equipment Fee $���`Z/ LJi�, <br /> Meter# <br /> Remote�$ Moving /Lifting Buildings Fee $ <br /> Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $ <br /> n Grading, Filling, etc.) <br /> ❑Copper <br /> Municipal Sewer Connection Fee $ _ <br /> Fire Fee $ <br /> ❑ PVC ❑Cast n 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 State Surchar e: Fee $_ � � <br /> undersigned understands and agrees under penalty of law g <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 activities requiring Total Amount Paid to City F00 $-� <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 and/or health department regulations, snd shall be This permit is not valid until the proper fee is paid and <br /> subiect to inspection, approval or reiection by the City. lt 1S 3 roved b an authorized Cit Official. <br /> Whenever so ordered, the undersigned agrees to conect pp Y Y <br /> any work found to be in violation of the conditions of <br /> this permit. <br /> Sign re of 'can Signatur of C�ty Official <br /> � <br /> �_ . Ct � �-�1,� <br /> Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt <br />