HomeMy WebLinkAbout1985-08-16 Permit, Water Well #8045GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Owner niku
Contrsctor1/Jc A\
City License No-----ILM---------------------
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 8045
^jAudl6 /f<^Datej
Address 1^IPs/'
Address_____________t __________________
State License No..
PERMIT TYPE AND FEE: ^^NEW □ ADDITION □ REPAIR
Inside Plumbing (#nxturcs __)
Water Meter (Size—)
Meter#
Remote #.
Municipal Water Co.mection
□copper □____
Municipal Sewer Connection
□ pVC GCast Q.
MWee SAC Charge
On Site Septic System
Fee S Water Well Fee
Mechanical Equipment Fee
Moving /Lifting Buildings Fee
Land Alteration (Excavation, Fee
Grading, Filling, etc.)
Fire Feerec 5
Fpp
Sprinkler System (Fire) Fee
Other: Fee
After-the-fact Investigation FeeFee S.
ACKNOWLEDGEMENT
The undevsifned hereby acknowledges receipt of this limited
permit* including acceptance of all 9edal Information,
terms, conditions or lequiiemenU wdttcn above. The
undersigned understands and agrees under penalty of law
that thU permit is stricUy limited in scope to the work,
activity or improvement specified: that this permit does
not grant any authority to do work or activities requiting
separate permit approvals; and that this permit does not
grant authority to violate any provision of any City
ordinance or SUte 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
subject 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.
Signatim s>f Applicant
TOTAL
State Surehaige:
Total Amount Paid to City
Fee X -SG
Fee
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
\(A>y\A:a^4k (£P)
Code: White-File Copy Canary-Cnipcctor ’i Copy Pink-Finance Copy Gold-Applicant's ReMpt