HomeMy WebLinkAbout12-29-1986 Permit, Septic System #8852Owner
GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
/ i'7 rA Consi~'
CITY PERMIT N9 8852
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__ 33 “^^ ft h,
_____ ^u.'rAuUiU^ Adte P.oQk.-^'-(J^ ■----------
^<39b'__________^City License No.
REMARKS AND SPECIAL COWITIONS
City _
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PERMIT TYPE AND FEE ^NEW □ ADDITION □ REPAIR □ REMODEL
Inside Plumbing (^fixtures )Fee S .Water Well Fee S
Fee S Mechanical Equipment Fee S
Fircpiace/Wood Stove Fee $
Moving/Lifting Buildings Fee S
Municipal Wiier Connection Fee S .Land Alteration (Excavation,Fee SGrading. Filling, etc.)□ Copper □Design Review Fee $
Municipal Sewer Connection Fee S .Fee S
□ PVC □ Qst □Sprinkler System (Fire)Fee S
MWee SAC Charge Fee S .Fee 5:
On Site Spetic S^tem Fee S .After-the-fact Investigation Fee S
ACKNOWLEDGEMENT
The undersigned hereby acknowledges axeiiH of ihis limiled pciniil,
including acccpuina* i>f all sivcial inromulion, terms. ctinJiliorvs iv
Tcquircmenis WTitten aKwe. Tlit undersigned understands and agrees
under penalty i>f law that this permit is strictly limited in saijv to the work,
activity or improvement specified; that this permit d<vs nvM grant any
authority todo work oratlivilics riHiuiringsrparaie permit approvals; and
that litis pemtitdocsnotgrantaulhoriiv to viobteany provision ofany City
ordinance or State bw, rule or rvgubtion. All work shall be done in strict
cvtmpliana* with all City ordinances, building codes and/or health
department regubtionv and shall be subject to inspection, approval or
rcjiYtion by the City. Whenever so ordered, the undersigned agrees to
cttmxT any work found to be in virtlition t>f the ittndilitms t»l this permit.
Signature
U 'A LijU^
TOTAL
Slate Surcharge:
Total Amount Riid to City
Fee $
Fee $'7s^v
This permit is not \’alid until the proper fee is paid and it is approved
by an authorized City Oflicial.
Signal^ of City Oflirial
Code: White—File Copy Canary —Inspector's Copy Pink—Finana* Copy Gold—Appltcanfs Receipt