HomeMy WebLinkAbout1986-8494 - general permit GENERAL PERMIT CITY PERMIT NO. 8494
CITY OF ORONO
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357 n -
Owner6t,�� ' s�!►�-/I'- Address
8 l - Address Contractor 2�
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City License No. State License No. — , &,
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑REPAIR
Inside Plumbing (#fixturesL3 Fee $ Water Well Fee $
Water Meter(Size_) Fee $ Mechanical Equipment Fee $
Meter#
Remote# Moving/Lifting Buildings Fee $
Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $
❑Copper n Grading, Filling, etc.)
Municipal Sewer Connection Fee $
Fire Fee $
❑ PVC ❑Cast n Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other,-, 1. o Fee $
On Site Septic System 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 State Surcharge: Fee $.AL1
undersigned understands and agrees under penalty of law
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 $
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.Ali 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 Signature of City O ficial
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Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receip'