HomeMy WebLinkAbout1984-08-09 Permit, Water Well #7558GENERAL PERMIT
CITY OF ORONO
CRYSTAL BAY. %IINNi:SOTA 55323
(61 2) 473.7357
CITY PERMIT NO. L 7558 ,
Dail. _ jq - 9 - 84-{
OwnerAddms 12 Q- $T l a r
Contractor - Q � 044 S4bJn t s W EAA— [Q Address _ JWU "n _
City License No. PEN Di N_[� State Llcenx No.. Z --7Z7
REMARKS AND SPECIAL CONDITIONS
Ilet RNIB TYPF• AND FGF ❑ NFW
Inside Plumbing 1 f ti mx_ 1
Water Mcler (Size_i
sileter M
Remote#
Municipal Nater C'omle:tlnn
❑Copp,'r E1 ------
Municipal Sewer Connc:then
❑ PVC ❑ ('est ❑
MWCC SAC Charge
ACKNOWLEDGENIFN7
❑ ADDITION
Fee Ste,_ I
Fee S
I cc S
FCC S
Fee
Ties undsrdpesd hsnb) stied—l.dps meript or this hmll.d
Psfmlt. In4eidmtt ''"'Isms ur sU 0-fal Intormed„n.
urns, .antLn,Ye- nee t.ttmnmenbe wnt!een sbrns. The
utsd.ween.d uod.r.4nd. -1 sp... und.r Iwnslts ut Ise
Mu the- P.emit e- .uktA IJn,iwd to rows to th. .W%.
.,elllts ,u Pr+Pren—.1 .P• 41.d. th.1 the. twnnil due,
nut pant seer .nth.,nn t„ du r.Ys 4-1 srtr\Itks requiring
..Paste twrmet .PPI—iJ, .red th.+ Nr• Permit drrs nut
pate suth,mt, v, \,.d.t, N\ I.r.n+Y r.n eel int t'lls
urdlnm. - "491 Ile' rul• .. rlsut.u..n %V ...Ys shall bw
dune In suxt rom PtJsn,• .nA ill l u, „rdwrsn..s, t eldlnte
.rxls snit..r besith drPatm.nt rep.tspun.. .nit MsY a
• .ubwet t., ieetP•, u..'. .PPI., -.J .V nk,P.,n be m• ('sits
r h•nr,er ..rdrrrd, in, se-w—sn.d .sr — In rum,t
sn, ..us !.sand r., ell, +n .-L..- 1 tie r„mm,..n, ..l
the. W r^+tt
Sign urc of Applicant
❑ REPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moving' Lifting Buildings
Land Alteration (Fxcavation.
Grading, Filling, Cie.)
other -
After -the -tact Investigation
TOTAL
Fee S
Fee S —440, p0
Fee S
FCC S
Fee S
Fee S
Fee S
State Surcharge. Fee S . 5D
30 � yo
Total Amount Paid to Cit) Fee S
This permit is not tand until the proper ke is paid and
it is appeosed h% An authorized City Official.
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Code White 1 de ( ur) Cmun tnq+and'a Copy Pink 1 inanar Cop) (kdd AppWiLm'. R"pt