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HomeMy WebLinkAbout1985-11-23 Permit, SAC #8208GENERAL PERMIT CITY OFORONO po-BOX01 (-RYSTAL BAY. b11K\ Ihl_)a� `l Owner ------ Contractor Cit) License No. RI -MARKS AND SPECIAL CONDITIONS Pl'.RMIT TYPE AND FF.F til N hwde Plumbing 4Otixturrs-1 cl Ty PI• RMnT No. ti„II� Date Address Address Statt: License %0. ❑ ADDITION ❑ REPAIR Fcc $ _ -—Iw'a1tr Well Water deter ISice _-► I•rr � deter# Remote Municipal water Conn tion ❑(-Opper Fee 5 \lunicipal SCu ewrr nnectinn 0 PVC- ❑ C-a.t [1_— Fee 5 \1WCC SAC charEe On Site Septic SII stem Mechanical Equipment Sloving,'Lifting Buildings Land Alteration (Excavation. Grading. Filling. et" Fee 5 -- ACKNOWLEDGEMENT — ACKNOWLEDGEMENT The undentgn.d Manna .rinur Mdp• rrrgDl ul this limited p.rmll. including .ccept•naa " f .y.dJ allorm.tlun. tom., eundlunne w nqulnm.ny rntt.n .bo.e. Thr done und•d und.nt.uit and .gree. under pendia of �r the I permit t ■talc dt Ilmltrd In .cope w the 'wk' as tl.lt .0 bnprov.lhenl .p.clll.d, that WIs We""trin n.d grant An%%.IrDrotJ•^ end 1h.t wV De rm It do.s not want V Permit HnA.W .nV prottllun of .n• C•ltt grant alhont /� wdn.nct or tint• punt• rllb r&a l`It oordln.nce.. budding dune M .trlct c.un Mian .nl r. tul.Uune..od .hall be cud.. .ndlnr h.Jtb drDart-- .r r.1.Cuorn by the Cit. eubMcl to b,rp.cum. sopr.r.J .d mall" to cone.' Wb.ne• w .rd.red. the n✓' ul the eaedlUom of .nr Iwnd W be e Ilj . 4of Ati_ . A, ttl t 6tuP CC _ irc FeeS ---- Fee S Fee S- -Fee S Fee _ Fee S Sprinkler System IEirel T fr ( Fee S ' thea... M7lire -I1k Cop) Canso - tn+pcctot-+iupl I Investigation Fee 5 101AL Stair Surcharge: Fee S Total Amount Paid to City Fee S This permit is not valid until the proper fee is paid anc it is approved by an authorized City Official. Signature of City Oflj itd pink I tn.n.e Cop) G0M-APPK=W%1rifP4