HomeMy WebLinkAbout05-27-1986 Permit, New Water Well #8482GENERAL PERMIT
CITY OF ORONO
CITY PERMIT NO.8482
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Date.
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Address
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State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE:
Inside Plumbing (^fixtures—)
^ NEW □ ADDITION □ REPAIR
Water Meter (Size—)
Meter#_______
Fee S.
Fee S.
Remote #.
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Municipal Water Connection
d Copper Q____
Fee S.
Municipal Sewer Connection
□ pVC dCast Q.
MWCC SAC Charge
Fee S
Fee S.
On Site Septic System Fee S.
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee S
Fee S
Fee S.
Fee S.
Fire,
Sprinkler System (Fire)
Other:______________
Fee S.
Fee S.
Fee S
After-the-fact Investigation Fee S.
ACKNOWLEDGEMENT
The undersiftnccl hereby acknowledges receipt of this limited
permit, including occeptance of all special Information,
terms, conditions or reaulrements written above. The
underdgned 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
separate permit approvals; and that this permit docs not
grant autliority to violate any provision of any City
ordinance or State law, rule or regulation. All work shaU be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
subiect to inspection, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of Applicant
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $ ^____
Fee S 30
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City OffiejaH
7^
Code: Wliltc-l-ilc Copy Canary-Inspector’s Copy Pink-Rnance Copy Gold-Applicant’s Receipt