HomeMy WebLinkAbout1985-7824 (gas hookup) GENERAL PERMIT CITYPERMITNO. �824
CITY OF ORONO ��� ��---
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 3-7357
Owner L�'�� � �s�'y�' Address �.�l��S 7` (_.(� ��(i� �
Contractor � a- � � � l 1\ Address 5����s ��C���7i (�,�.� '''�- � �-a�u
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) 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 $
� Grading, Filling, etc.)
❑Copper
Municipal Sewer Connection Fee $ —
Fire Fee $
❑ PVC ❑Cast n Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other: Fee $
On Site Septic System Fee $ After-the-fact Investigation Fee $
ACKNOWLEDGEMENT TOTAL
The undersigned hereby acknowledges xeceipt of this limited
pexmit, including acceptance of ell special information, �
terms, conditions or requirements written above. The
undersigned understands and agxees under penalty of law State Surcharge: Fee $
that this permit is strictly limited in scope to the work,
activity or irnprovement specified; that this permit does Q f[�`�/ '
not grant any authority to do work or activities requiring Total Amount Paid to City Fee .p I�v �
sepazate 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
�oaes �aior health department regulations, �a sheu be This permit is not valid until the proper fee is paid and
sub;e�t to inspection, approval or rejection by r�e c�ty, it is a roved b an authorized Cit Official.
Whenever so ordered, the undersigned agrees to conect pp Y Y
any work found to be in violation of the conditions of
this permit.
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Signature of Applicant Si a ur of City Official �
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Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanYs Receipt