HomeMy WebLinkAbout08-29-1986 Permit, Septic System #8649GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612) 473-7357
Owner __
Conlractor.(L/M^ m//
City Uoensc No.
REMARKS AND SPECIAL CONDITIONS
Address.
Address.
City _
CITY PERMIT N9 8649
Dale
Pi i
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nr\ 9b- ^jL.po^ — ^
PERMIT TYPE AND FEE
Inside Plumbing (^flxturcs__
Water Meter (Size___)
Meter #__________
>4NEW
Fee S
Fee $
□ ADDITION □ REPAIR
Remote H
Municipal Witcr Connection
□ Copper □ ___
Munidpal Sewer Connection
□ PVC □ Cast □
MNS'CC SAC Charge
On Site Spctic S>'stcm
Fee S
Fee $
Fee S_________
Focs 2S^
□ REMODEL
Water Well Fee $
Mechanical Equipment Fee $
Fircpiacc/Wood Stove Fee $
Moving/Ufting Buildings Fee $
Land Alteration (Excavation,
Grading, Filling, etc.)Fee S
Design Review Fee S
FiiB .. _ ..................Fm» «
Sprinkler System (Fire)Fee 5
Orhor Fee $
After-the-fact investigation Fee $
ACKNOWLEDGEMENT
The underMpnol lieaby ackmmledges reaipl of this limited permit,
irKtuding aacpLincc of all sjxvial information, term^. corxJiliom or
a*quircmenis written ahme. The undenagned understands and aga‘cs
under penalty of law that this permit tssiricily limited in 5co|v to the work,
activity or improvement 5(vcified: that this permit docs not gram any
authority to dc» work or activities a'i|uiring separate permit approvals: anil
that this fvrmil dtx's not grant authority to viobte any piovisitm of any City
ordinarxx* or State bvv. rule or a*gubiion. All work shall be done in strict
compliance with nil City rrrdinances, building axles and/or health
department regubtions. anil shall be subject u» iRsjxxriion. approval or
rejection by the City. WTienewr stv ordered, the undersigned agrees to
cTrrnxt any work fouixl to be in vioblion of the a>nditions of this permit.
TOTAL
Slate Surcharge:Fee S
Signature of Applicant
(UJLQl\
Total Amount l\iid to City Fee
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Oflicial.
Signature c^ily Oflidal ^ a
-O-
Code-: White-nie Copy Canary—Inspcxior's Copy Pink—Rnanev Copy Gold—Applicant's Receipt