HomeMy WebLinkAbout1985-11-14 Permit, SAC #8189GENERAL PERMIT CITY PEPMITNO. 8189
CITY OF ORONO
Date
P.O.BOX Gti
_
CRYSTAI. BAY. MINNESOTA 55323
ia12)473-7357
Owner -�t' t 1 ) t Address i` 'It t t'�
Contr:wtor Address
City License No,
RIAIARKS AND SPECIAL CONDITIONS
State License No
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ Ill I -AI Ft
Inside Plumbing (Hixturcs_1
Fee
5 —
W--Ier Metef ISlle_)
FCC
S _- --•
Meter
Fee
S
Remote !
Fee
S
Municipal Water Connection
Fee
S _.-
❑Copper Q
Fee
S
%luolcipal Scher Connection
Fee
S - ---
❑ Pvc• ❑cast fl
Kher - i C
Fee
MWCC SAC Charge
Fee
S _
the Site Septic System
Fee
S
ACKNOWLEDGEMENT
in• undrr.i tnrd hobby witnovtlydpr trrrlpl o this tam(laid
y1rm 11, tnl tudmt acerptaner nt dl spreW Inf,,w-Unn•
tl nn •, . ndaInns .4 "qut"mrnb rnitan obwr The
unJr ratnlJ un demand, and 'Qrr. under Wntltr ut lar
that Ila l+ W,mat a. ,tna UY bmltrd In —P. 1.. tar roti,
artaHatl .4 u,aptu•rmrtat we"ned. that this Dean It dura
-4 s,Aal ant autbontl to du calk o, ar UISU-. osal-Mnt
vDuatr Penna( apDtu•als. and that this Wrnaat dura nut
'tint au Nl.nto W 1to4M ant pl wlrlM of All CIIF
rtlhnanrl nr Stall tor.,uk o, "NlaUun. AU ruck daoU ba
J.w1, to atn,t rumph, rt%h aU fits ardan,sra— budduat
...,t•• and ..r heath dr `u mt "NLUuna, And Jail I.
wbN1t lu Uup"Um. aDD,aral .4 nhr Ion ba Wr Cth.
'Ahrnr.ra w 14,11"d. Nr ""'I" an.If mar— to comet
ant r14k found to br in 'lcdau,.n of the ronJauun, nl
Ihu ptrmit.
Signature o can
V y
u'k NTtite Ilk Cup) Canar) Ingacctot's Cup)
stet Well
Fee
S
rchmil..11 1-'111111I11Cllt
Fee
S
using /Lilting Buildings
Fee
S
and Alteration (Excavation,
Fee
S
Grading, Filling, etc.(
ire
Fee
S
prinkler System (Fire)
Fee
S
Kher - i C
Fee
S
fter•the•fact Irtsestigation
Fee
S
TOTAL
State surtilarge
Total Amount Paid to Cita
Fee S
Fee S
This permit is not valid until the proper fee is paid and
1t is approved by an authorized t'ity t)Iftcial.
Signatu • of City Om lal `
Polk 1 inane Cup) (idd-APPOMI'S RSCd(tt