HomeMy WebLinkAbout11-25-1985 Permit, Septic System #8203GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
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CITY PERMIT NO. 8203
Owner.
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Address.
Address.
City License No..
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State License No..
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE:
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□ ADDITION
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□ REPAIR
Inside Pkinibing (Ifixtures__)
Water Meter (Size__)
Meter# _____________
Remote #.
Municipal Water Connection
_opper
Municipal Sewer Connection
□ pVC DCast □.
MWee SAC Charge
On Site Septic System
Fee S.
Fee S.
Fee 3.
Fee S
Fee S.
Fee S.
WaUTWcll
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fire.
Sprinkler System (Fire)
Other:_____________
After-the-fact Investigation
Fee S.
Fee S.
Fee S.
Fee S.
Fee S.
Fee S.
Fee S.
Fee S.
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special information,
terms, conditions or requirements written above. The
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 actiWtles requiring
separate permit approvals: and that this permit does not
grant authority to \iolate 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
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 bo in xiolatlon of the conditions of
this permit.
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Signature of Applicant - .
TOTAL
State Surcharge:
Total Amount Paid to City
Re
Fee %2S1SIL
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signati^ of City Official
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Code: WTilte-Filc Copy Canary-Inspector’s Copy Pink-Finance Copy Gold-Applicant’s Receipt