HomeMy WebLinkAbout12-29-1986 Permit, Water Well #8856Owner
Coniractor
City License No.
GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
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REMARKS AND SPECIAL CONDITIONS
Address.
f)on Address
____________________City
CITY PERMIT N9 8856
Date
/yi /o
'he Olc^c?/ C Uy
PERMITTYPE AND FEE:
Inside Plumbing (^fixtures )
Walter Meter (Size )
Motor H
j^^NEW
Fee S
Fa* S
Romnto H . .
Munidpal Wetter Connection
□ Copper □
Fee S
Munidpal Sewer Connccrion
□ PVC □ Gist □
Fa* S
MWee SAC Charge Fee S
On Site Spetic Sjstem Fee S
□ ADDITION □ REPAIR □ REMODEL
Water Well Fee $
Mechanical Equipment Fee $
Fircpiacc/Wood Stove Fee S
Moving/Ijfu'ng Buildings Fee S
Land Alteration (Excaration,
Grading, Filling, etc.)Fee $
Design Review Fee $
Fin»Ft><» $
Sprinkler System (Fire)Fee $
Ollipr Fee $
After-the-fact Investigation Fee $
TOTAL
State Surcharge;Fee $
Total Amount Paid to City Fee $
ACKNOWLEDGEMENT
The undefMgned hereby acknowledges receipt of this limited permit,
including aavptance t>f all .s(xxul informaiinn. terms, additions rx
requirements written aNwe. Tht undersigned understands and agrees
under (vnaliy of bw that this permit is strictly limited in verpv to the work,
actisiiy ix imprownKnt spxificd; that this |x*rmit does not grant any
authority lodowork oractisiiics requiring separate permit approsak anil
that this permit d* not grant authority to \iob te any prousion of any City
ordinance or State bw. rule or n^mbuon. All work shall be done in strict
wmplbncc with all City ordinances, building codes and Ax health
department regubtions, and shall be subject to inspection, approsal or
rejation by the City. Whcncscr so ordered, the undersigned agrees to
C'lrravt any work found to be in sir4ation i>f the conditions of this permit.
Hu's permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
Signature of Applicant
Signature of City Offidal / )
CckJ l*: While—File Copy Canary—Inspector ’s Copy Pink—Finance Copy Gold—Applicant’s Rcoript