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HomeMy WebLinkAbout1988-001472 - new well PERMIT CITY OF ORONO PERMIT TYPE: '- , FW��.�_' WATERI 1335 Brown Rd.South•P.O.BOX 66 Permit Number: {131 ' Crystal Bay, Minnesota 55323 Date Issued: 11 X23 (612)473-7357 SITE ADDRESS: 4798 NORTH SHORE DR P . I .N. 07-117-23-:322-0013 I DESCRIPTION: _ewer & Water Permit Type WELL =ewer & Water Werk Type AES10E E I 1 f REMARKS: x STAFF MUST =-1K SITE OF NEW WELL. CONTRACTOR MIST SUBMITTED A COPY OF STATE WELL RECORD . FEE SUMMARY: Base Fee $30.00Surcharge L•11 7 Lit L'!!L'1 Til ! l!T Total Fee - __ $30.50 real - „L•A L91.L!T JV a VV 77 V1 LLIT r,..'V .. fir_ T( �•: _ !CLL-L1! f?it!% !QL. dr711.VL_.L' L•111iy !4 V2 _...•"7J• Co �PIQR: -- -- 4972:3340 0W 'TS CLINT 7 a z HWY 12 E 47`8 NORTH SHORE DR DELANO MN 552-:228 CRYSTAL BAY MN 55364 '2') '-472-:-:340 THCUNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS' II L• SPECIFIED'ORDINANCES AND AGREES. TO 0+3 ALL WORK IN STRICT' COMPLIANCE W_I TH ALL CITY OF ORON0 ORD I NANC:ES AND STATE -C'+F MINNESOTA BUILDING COM, REQV I REMENTS PPLICANT/PERMITEE SIGNATURE ISSU BY:SIGNATURE INSPECTION RECORD CITY OF ORONO PERMIT TYPE: SEWER WATER 1335 Brown Rd.South•P.O.BOX 66 Permit Number: 001 47' Crystal Bay, Minnesota 55323 Date Issued: (612)473-7357 SITE ADDRESS: APPLICANT: 4798 NORTH SHORE OR DR I LLCO C 6 12? 972—'-11".-,.A() PERMIT SUBTYPE: TYPE OF WORK: WELL RESIDENCE INSPECTION TYPE DATE INSPTR. INSPECTIONDATE INSPTR "OUCH—I N -INAL REMARKS: STAFF MUS*T iX.'. SITE OF NEW WELL. CONTRACTOR MUST S=,UEV I TTED A COPY i�F STATE WELL RECORD. ALL 'NSPECTIQN= MUST .BE CALLED 24 HOURS IN ADVANC , 'THI S CARO UST.': 3E -POSTED-'°7, INA FISP I CHOWS PLACE ON THE PREMISES ON WHICH THE- WORK. I" TG' " .BE� NE. / DATE TIME ORONO CALLED IN _CTION NOTICE �� SCHEDULED W—'2-3 — MIT NO. Q COMPLETED I I -�3 Z .DDRESS OWNER CONTR TELEPHONE NO. 7Q— 3yV ❑ FOOTING ❑ PLUMBING RI O SITE INSPECTION O FRAMING ❑ PLUMBING FINAL ❑ EXCAV./GRADING/FILLING ❑ INSULATION ❑ MECHANICAL ❑ LAKESHOREIWETLANDS ❑ WALL BD. O WATER HOOKUP ❑ LICENSING LIJ O FINAL O METER SET/TURN ON ❑ COMPLAINT LLQCo ❑ PROGRESS O SEWER HOOKUP ❑ FOLLOW-UP O DEMOL O SEPTIC INSTALL. O SEPTIC FINAL Q ❑ FIRE PREV. O SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER Z ❑ WELL TEST PUMP ❑ = COMM TS J PAP W I J Z a y W a J O cc O k W Q 2 cc W e1 a W cc W WORK SATISFACTORY:PROCEED ❑ PHOTO TAKE Q O CORRECT WORK&PROCEED V ❑ CORRECT WORK CALL FOR REINSPECTION BEFORE COVERING O CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RET N. O STOP ORDER POSTED.CALL INSPECTOR. ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance. Owner/Contr. on site Inspecto -7357 White/lnspe is File Canary/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICEHEDULED PERMIT NO. MPLETED / lLf ADDRESS 117 /y0 �i—c � O/C OWNER ONTR. TELEPHONE NO. ❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION ❑ FRAMING ❑ PLUMBING FINAL ❑ EXCAV./GRADING/FILLING ❑ INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS ❑ WALL BD. ❑ WATER HOOKUP ❑ LICENSING ❑ FINAL ❑ METER SET/TURN ON ❑ COMPLAINT Q ❑ PROGRESS ❑ SEWER HOOKUP ❑ FOLLOW-UP y ❑ DEMOL ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL Q ❑ FIRE PREV. 0_,VPTIC MAINT. ❑ FIREPLACEIWOOD BURNER Z ELL TEST PUMP ❑ i COMMENTS: . K4 - /7 C--. j 0 a cc 0 4. W cc Q Z W W cc j d W W WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN ❑ CORRECT WORK 8 PROCEED ❑ CORRECT WORK CACI FOR REINSPECTION BEFORE COVERING :1CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN. ❑ STOP ORDER POSTED.CALL INSPECTOR. ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance. Owner/Contr. on site Z7 Inspector PA473-7357 White/Inspector's File Canary/Site Notice