HomeMy WebLinkAbout11-06-1986 Permit, Plumbing #8774OvsTicr
Contractor
City License No.
GENERAL PERMIT
CITY OF ORONO
RO. BOX 66
CRYSTAL BAY. MINNESOTA 55323
^ (612)473-7357
/ j (em a n Pi m h •/- h! /%
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT N9
II h
8774
Date
Address
Address
Citv _
f) bin.\c/a^
jy\C{iOle
PERMIT TYPE AND FEE
Inside Plumbing (^fixtures ^3)
Water Meter (Size___)
Meter//_____________
NEW
Fee S
Fee S
□ ADDITION □ REPAIR
Remote #
Munidpal Water Connection
□ Copper □ ____
Munidpal Sewer Connection
□ PVC □ Cast □
MWee SAC Charge
On Site Spctic System
Fee S
Fee S
Fee S
Fee S
□ REMODEL
Water Well Fee S
Mechanical Equipment Fee S
Fireplace/Wood Stove Fee S
Moving/Lifting Buildings Fee $
Land Alteration (E.\cavation,
Grading, Filling, etc.)
Design Review
Fee S
Fee S
Firp F pp S
Sprinkler System (Fire)Fee S
Dthor Fpf* S
After-the-fact Investigation Fee S
ACKNOWLEDGEMENT
The undeRipned hca*b\ ackmmledger receipt of ihi^ limited permit,
irKludinp aaTpUina* of all ^plx^al infornution, terms, conditions or
renuircmcnts written abovv. The undersigiH'd uixlersiands and agrees
under fxrnaltyof law that ihis permit isMricily limited in »co|x* to the work,
activity or improvenK*nt sfccified; that this permit d(vs not grant an\
authority to do work or activities requiring vparale permit approvals; and
that thlspemiit dtx:s not grant authority to viohteany provision of any City
ordinance or Stale bw. rule or rrgubuon. All work shall be done in strict
comptbnee with all City ordinarKcs. building axles and/or health
department regubuonv. and shall be subject to inspectio.i. apprmal or
rejanion by the City. Whenever so ordered, the undersigned agrtvs to
airaxt any work found to be in viobtion r^f the amditions of this permit
TOTAL
State Surcharge:
Touil Amount Riid to City
Rc S
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Oflicial.
Signature of Applicant
! 0
Signature of City Oflicial /
Code: White- f'ile Copy Canary™ Inspaior*s Copy Pink—Finance Copy Gold —Applicanfs Receipt