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1984-11-15 Permit, Septic System #7717
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2555 Countryside Drive - 04-117-23-14-0006
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1984-11-15 Permit, Septic System #7717
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Last modified
4/3/2025 11:47:12 AM
Creation date
4/3/2025 11:40:30 AM
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Template:
x Address Old
House Number
2555
Street Name
Countryside
Street Type
Drive
Address
2555 Countryside Drive
Permit Number
7717
PIN
0411723140006
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GENERAL PERMIT <br />CITY OF ORONO <br />P.O.BOX 66 <br />CRYSTAL BAY. MINNESOTA 55323 <br />(6 12) 473-7357 <br />Owner 'SO_At- k- e- ✓ l�.t. Dam . <br />Contractor Jit tT n in 4 e <br />City License No. :�:200 q <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE <br />Inside Plumbing (#fixtures_ ) <br />❑ NEW ❑ ADDITION <br />Fee S __ <br />Water Meter (Size—) Fee S <br />Meter # _ <br />Remote # <br />Municipal Water Connection Fee S____ <br />❑Copper <br />Municipal Sewer Connection Fee <br />❑ PVC ❑ Cast r- <br />MWCC SAC Charge Fee S . <br />On Site Septic System <br />ACKNOWLEDGEMENT <br />CITY PERMIT NO. 7717. <br />Date //— /r'— !?!K - <br />Address <br />Address _�3 do o o MAJIF 1 <br />/ <br />State License No. <br />❑ REPAIR <br />Water Well <br />Fee S <br />Mechanical Equipment <br />Fee $ <br />Moving /Lifting Buildings <br />Fee $ <br />Land Alteration (Excavation, <br />Fee $ <br />Grading. Filling, etc.) <br />Fire Fee S <br />Sprinkler System (Fire) Fee S <br />ther: Fee S <br />Fee S -7 S, 0 OlAfter-the-fart Investigation Fee S <br />The undersigned hereby acknowledges receipt of this Welted <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 activities requiring <br />separate 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. Ali work sball be <br />done in strict compliance with all City ordinances, t•ailding <br />codes and/or health departmert regulations, and shall be <br />sublect to inspection, approval or resection 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 />S' of Appli01 <br />, <br />TOTAL <br />State Surcharge: <br />Fee $ _e !:;Y) <br />Total Amount Paid to City Fee S <br />This pennit is not valid until the proper fee is paid and <br />it is approved by an authorized City Official. <br />Signature of City Official <br />Code: White I He Copy Canary Inspector's Copy Pink—Finance Copy Gold- Applicant's Receipt <br />
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