HomeMy WebLinkAbout1985-11-27 Permit, Sewer Connection #8212ANER
AL PERMIT clTYPERMITNO. 8212
CITY OF ORONO Date
1' O.BOX 60
cKYSTAL BAN'. MINNESOTA 5533
16121373-7)'j /
Owner
(L Address l �l
Address
('ontra741±;
tor
City License No.
/",State License No.
tT�
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: 10 N1 w ❑ %Ulifl IUB ❑ REPAIR
I11.1de Plumbing 4fl-miures-_) Fee 5 _ - --
NiterMeter (Site_) Fee S — —
Sleter!
Remole A
%lunicgtal Water Connection Fee S _ — —
❑Coplkr n
Municipal Scwer Con ection Fee S —'--
O Pvc yCast ❑_
MWCC SAC Charge
///��� Fee S .
on Site Septi System
ACKNOWLEDGEMENT
Fee S
The und-entm.d h. -b, •,tnor t.dp- ren IV of thl-hmtlyd
p,,11. tndudln, •«rP Wcr of aU W-"' Inlutm atlon.
cundwons or requirements rnttrn abme. Th-
undrrrtU+e4 undo mond- and •pee- nde, P"011 - .-I ta.
that this prrwtll 1. -tU
n<. u meted In ec.,P- to th ..,r►.
acUNb ,u lm Pro.rnt-nt -Pra11Md. that this permat d—
A Grant an- •uthunn In d„ .rsk tit -ctr-tUe- r.qulnna
at &hit
pant wNunlr to
•t ui-lr man �P-a son .1 " Cl,,
aU b•
urdlnu rr ret Sims Ir., rule ,, r-Nl-Uun. AU work .n
door In -tn<t .umpUan.r rich as AlplaV art.�l
atld h.0 b"
<ne.- .red: nr I-ealth deoartm- .
tubi.,( to k--PKUon. WPrmal w nMe.rlNcumct
th'brn..er w otdrted, the und-signed aa---
am .,Wk loured u- b. In j.a.u— til the cnndlllnn- of
thio 10armit
Signature of Applicant
Fee S --1
Equipment Fee S —1
wing Lifting Buildint<s
nd Alteration (Excavation.
Grading. Filling. etc.)
System (Fire)
fter-the-fact lnvestigation
TOTAL
Fee S
Fee S -
Fee S�—
Fee S�—
Fee S —
Fee S
State Surcharge: Fee S —
Total Amount Paid to City rce yz=
This pennit is not valid until :he proper fee is paid ani
it is approved by an authorized City Official.
Signatul� City
Cd.k white- t ne C/y>> Canary' '. i Iy Pink -F mance COPY
cold- Appacal VI R.atpl