HomeMy WebLinkAbout06-17-1986 Permit, Septic SystemGENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
CITY PERMIT NO.8527
Date pi
Owner,
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Address C
City License Nn. _______ State License No.
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REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE:
Inside Plumbing (^fixtures__)
Water Meter (Size__)
Meter#_____________
D^W □ ADDITION □ REPAIR
Remote #.
Municipal Water Connection
.-opper
Municipal Sewer Connection
□ pVC DCast Q.
MWCC SAC Charge
On Site Septic System
Fee S
Fee S _
Water Well Fee
Mechanical Equipment Fee
Moving /Lifting Buildings Fee
Land Alteration (Excavation, Fee
Grading, Filling, etc.)
Fire Fee
Fee Si
Car, cree o
Fee S
Sprinkler System (Fire) Fee
Other: ^ Fee
After-the-fact Investigation FeeFee S ^S.07^
ACKNOWLEDGEMENT
The undenifiitd hcteby ackaowlediee ftceipt of this limited
peimil, locluding eeceptence of ell iPMiel faifoimetloii.
teimi, condltioiu or lequiiemeiiti wdtten above. The
uadenigaed UBdentendi end agrees under penalty of law
that this permit Is strictly limited in scope to the wocfc,
activity or impiovcment ipecifledi that this pennit does
not grant any authority to do work or activities requiring
separate permit approvals: and that this permit does not
grant authority to violate any provMoa of any City
ordinance or State taw, rule or regulation. All work draD be
done In strict compiiance with all City ordinances, building
codes and/or health department regulations, and shall be
subiect to inspection, approval or relcction by the City.
Whenever so ordered, tiie underslvied agrees to correct
any work found to be In violation of the conditioiu of
this permit
Signature of Applicant
TOTAL
State Surcharge:
Total Amount Paid to City
Fee »
Fee $.Z5L^?.
This pennit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Offipwl
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Code: White-File Copy Canary-Inspector's Copy Pink-Finance Copy Gdd-i^>plictnt*i RcMpt