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11-10-1986 Council Packet
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11-10-1986 Council Packet
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GE�1 $AL PERMIT <br />bF ORONO <br />V,j P.O. BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612) 473-7357 <br />Owner Akso n <br />Contractor-1;-WAIl 5 VJ E ST <br />City License No. <br />CITY PERMI"T lr? 8735 <br />Date _ A2 —16 - 81L <br />Address SDO 7 n ZtAwf} <br />Address 5201 BArFe e & Tf<-,4 <br />City <br />REMARKS AND SPECIAL CONDI[TIONS <br />Q LL Wor K 1 S Sub l A T?) 4C ��n � �6 r>a US""�� <br />151Eltha A1JVf',6t1FD lMNl CzuiAr^ r (` — Le wr -Ae -Fo r- MA I/ L.o�Taye_kjC.-t" WALL <br />PERMIT TYPE AND FEE - <br />Inside Plumbing (#fixtures ) <br />Water Meter (Size ) <br />Meter # <br />Remote # <br />Municipal Water Connection <br />❑ Copper ❑ <br />Municipal Sewer Connection <br />O PVC ❑ Cast ❑ _ <br />MWCC SAC Charge <br />On Site Spetic System <br />ACKNOWLEDGEMENT <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />Fee $ <br />The undersigned hereby acknowledges receipt of this limited permit. <br />including acceptance of all special information, term,, conditions o, <br />requirements written above. The undersigned understands and agrees <br />under penalty of taw that this permit is strictly limited in scope to the work. <br />activity or improvement spectrred; that this permit does not grant any <br />authority to do work or acti cities requiring separate permit approvals, and <br />permit <br />that this does not grant authority to violate any provision ofany City <br />ordinance or State law, rule or regulation All work shall he done in strict <br />compliance with dl City ordinances, building codes and/or health <br />department regulations. and shall he subject to inspection, approval or <br />refection by the City. Whenever so ordered, The undersigned agrees to <br />o ct any work nd ttf be in violation of the conditions of this permit <br />IG.0 <br />10-16 <br />Water Well <br />Mechanical Equipment <br />Fireplace/Wood Stove <br />Moving/Lifting Buildings <br />Land Alteration (Excavation, <br />Grading, Filling, etc,) <br />Design Review <br />Fire <br />Sprinkler System (Fire) <br />Other. <br />After -the -fact Investigation <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />rrf The— Csritir <br />O�EL rrl rid <br />Fee $ <br />Fee S <br />Fee $ <br />Fee S <br />Fee $ _5-0.0 6 <br />Fee $ <br />Fee S <br />Fee $ <br />Fee $ <br />Fee $ S47 <br />Fee $ 5-0 <br />� <br />Fee $ lea . J <br />This permit is not valid until the proper fee is paid and it is approved <br />by an authorized City Official. <br />
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