HomeMy WebLinkAbout1984-7591 - general permit GENERAL PERMIT CITY PERMIT NO.
CITY OF ORONO
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612)473-7 57
Owner Address L�
Contractor Address 4 � G �I 04-AL
City License No. l �[� State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: )§-NW ❑ ADDITION ❑ REPAIR
Inside Plumbing( # fixtures ) Fee $ On Site Septic System Fee $
Water Meter (Size ) Fee $ Water Well Fee $ 39
Meter #
Remote# Mechanical Equipment Fee $
Municipal Water Connection Fee $ Moving/Lifting Buildings Fee $
❑Copper ❑ Land Alteration (Excavation, Fee $
Grading, Filling, etc.)
Municipal Sewer Connection Fee $
❑ PVC ❑ Cast ❑ Other: Fee $
MWCC SAC Charge Fee $ After-the-fact Investigation Fee $
ACKNOWLEDGEMENT TOTAL
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special information,
terms, conditions or requirements written above. The v
undersigned understands and agrees under penalty of law State Surcharge: Fee $
that this permit is strictly limited in scope to the work,
activity or improvement specified; that this permit does ��
not grant any authority to do work or activities requiring Total Amount Paid to City Fee $-30 .
separate permit approvals; and that this permit does not
grant authority to violate any provision of any City
ordinance or State law,rule or regulation. All work shall be
done in strict compliance with all City ordinances,building
codes and/or health department regulations, and shall be This permit is not valid until the proper fee is paid and
subject to inspection, approval or rejection by the City. it is approved by an authorized City Official.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of Applicant Sig a e�ofCity�OOffici f �(
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Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt
DATE TIM
CITY OF ORONO CALLED-IN B—.2q �7/ 0%AID
INSPECTION NOTICE SCHEDULED "2 / st GQ
PERMIT NO. COMPLETED
ADDRESS (99,eklr0AJeAL1JA,
OWNER IJA CONTR. S7-OD04A
TELEPHONE INO.
❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING ❑ MECHANICAL ❑ EXCAV./GRADING/FILLING
❑ INSULATION ❑ WATER HOOKUP ❑ LAK ESHORE/WETLANDS
❑ WALL BD. ❑ METER SET/TURN ON ❑ LICENSING
W ❑ FINAL ❑ SEWER HOOKUP ❑ COMPLAINT
LL ❑ PROGRESS ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
Q ❑ DEMOL. ❑ SEPTIC MAINT. ❑ SEPTIC FINAL
Q ❑ FIRE PREV. NeWELL TEST PUMP ❑ FIREPLACE/WOOD BURNER
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Q COMMENTS:
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pW ❑ WORK SATISFACTORY: PROCEED ❑PHOTO TAKEN
❑ CORRECT WORK&PROCEED
V ❑CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
❑CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
❑STOP ORDER POSTED.CALL INSPECTOR.
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. on site
Inspector 41A 4Z 473-7357
White Copy/Inspector's File Gold Copy/Site Notice