HomeMy WebLinkAbout1983-07-11 Permit, Septic Repair #7233'ENERAL PERMIT
CITY OF ORONO
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P.O.BOX 66
CRYSTAL BAY, MINNESOTA 5533
(61 2) 473-7357
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CITY PI Rh11T NO. 7233 1
Date
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Contractor J � � 0m IVSUI� AddressQ�/�N/!�l G S [ D
City License No. State Li;:ense No. _
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE: AND FEE: r NEW ❑ ADDITION
Imide Plumbing ( # fixtures_. ) Fee S
Water Meer (Size_) Feta $
Meter #
Remote #
Municipal Water Connection
Hee S _..
❑ Copper r ._.
Municipal Sewer Connection
Fee S
❑ PVC ❑ Cast CL�
MWCC SAC Charge Fee $
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit. including acceptance of all xsecial information.
terms. conditions or requirements written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly Umited in scope to the work.
activity or improvement specified; tha•: this permit 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 provision of any City
ordinance or State !aw. rule or regulation. All work shall be
done in strict compliance with all City ijordinances. building
codes and/or health department regulations. and shall be
sublect to inspection, approval or relection by the City.
Whenever to (ordered. the undersigned. agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature 40plicant
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Code White - I file Cupy Conary Inxpc1 tint's Copy
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On Site Septi: System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation.
Grading, Filling, etc.)
Other:
After -the -fart Investigation
TOTAL
Fee S Zo eyo
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
:tate Surcharge: Hee S
0
S"D
1-otal Amount Paid to City Fee S ZO
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Silmature oi" Cite Official
Pink I inance Cope Gold Applicant's Receipt