HomeMy WebLinkAbout1985 - 8090 (sewer connect)GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
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Contractor ( X
Address.
Address.
City License No..
CITY PERMIT NO. 8090'
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State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ^
Inside Plumbing (#flxtua*s__)
Water Meter (Size—)
Meter#
^ NEW □ ADDITION
Fee !s _ _
□ REPAIR
Water Well Fee
Fee <:Mechanical Equipment Fee
Remote#Moving /Lifting Buildings Fee
Municipal Water Connection
ncnppi'T n
Fee .C Land Alteration (Excavation,Fee
Grading, Filling, etc.)
Municinal Sewer Connection
i^PVC Dcast n
MWee SAC Charge
Fire FeeFee 5 J
Fee S
Sprinkler System (Fire)
Other;
Fee
Fee
On Site Septic System Fee S After-the-fact Investigation pP0
ACKNOWLEDGEMENT •TOTAL
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The undertigned hereby ecknowlcdgei receipt of thUUmlUd
permit. Including accepUnce of all ipeclal Infonnalion.
teims, conditions or requirements unltten above. The
undersigned undcntands 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 authority to violate any provision of any City
ordinance or State law, nile or regulation. All work ahaU be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
subiect to Inspection, approval or reiection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in \iolation of the conditions of
this permit
Signally of Applicant / • ^
\
State Surcharge:
Total Amount Paid to City
Fee S ^60
Fee
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature oi City Offici^
V
Code: White-Rlc Copy Canary-Inipcctor’s Copy Hnk-FInancc Copy Gold-Applicant's Receipt
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□ FOOTING
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□ INSULATION
□ WALLtO.
□ FINAL
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□ FmCFNEV.
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a MECHANICAL
□ WATEN NOOKUF
□ METEN SET/TUNN ON)Hcw^'WIVEN NOOKUF
O SEFTIC INSTALL.
□ SEFTIC MAINT.
□ WELLTE8TFUMF
a SITE mSFECTlON
□ EXCAV./ONAOINO/FILLINO
□ LAKESNONflWETLANOS
a LICCNSMO
□ OOMFLAINT
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□ MONK SATISFACTONV: FNOCEEO
□ CONNECT WORK O FNOCEED
a CORRECT WORK. CALL FOR NEINSFECTION KFONE COVENINO
□ CORRECT UNSAFE CONDITION WITHIN HOURS. INSFCCTOR WILL RETURN.
□ STOF ORDER FOSTEO. CALL mSFECTOR.
□ INSFECriON REOUIRED. CALL TO ARRANGE ACCESS.
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