HomeMy WebLinkAbout1986-04-28 Permit, SAC #8439GENERA
L PERMIT CITY Pt: RMIT NO. 8439,
CITY OF ORONO „ate G�
CRYSTAL BAY, MINNIiSOTA 553:3
t612) 473-7357 T
l U
J . Address
Address
untractor
State License No.
'ity License No•
RL' MARKS AND SPECIAL CONDITIONS
Pt.-R&IIT TYPE AND VLF: ❑ NI:W ❑ ADDITION ❑ RI- .1'AlK
Inside
Fee S Water Well
PlumhinglMfirtuRsll
Fte S _ - _ Mechanical Equipment
Water Meter (Sire _t
Sletcr# \toning Litling Buildings
Kepone
Land Alteration (Excavation.
Municipal Water Cuntion
Fre S _ - — -- Grading. Filling, etc.)
❑c,per
;(Municipal Sewcf connection Fee S
❑ I'V( ❑ Cast ❑� I )
MWCCSACCharge
Fee S_`�!�'�
On Site Septic S) aem Fee ',_�
ACKNOWLEDGEMENT
7•11• uuderwgn.d h.raby wknuw1.111•1 receipt ..t this Um Red
ecjsj
yetmlt. crndtUons fit Vquimmruts rnllen abune.ation. The
terms.
undenagned undpennitrnLnM anJ signers undo prnalN of U.
pe
this
t 4,w unprwrnienll wecifled. tth. is uthis psrmlt does
nen grant sins authunts to do work or KU iU@s lequinng
not
lepw.te penult apOr-alai, ns�siprovisiot Ws n t of apult ps City
grant authority to
ordinsince ur stale law. rule sir regutation Ali work 1hall be
done in Witt ctd11Pliarire with as City onitnaicei. building
codes andlnr h@.,M dsiVartm.at regulations, and 611011 b4,
wt•lecl to Utspeetim. aODrord u< nNc Uon by Uie Coy.
to correct
w'henrler w oni jed. Liss undenignsd &9""
4,111wn k found to by in lonlauon of the cu -bit" l of
this pennit.
Signet tr o1 Applicant
✓ t
Can,o Inw"tor'sCop)
C'odc w'hitc 1 dot .gyp)
Fee S
Fee S _ —
Fee S
Fee S
ire
Fee S
prinkler System (FireI Fee 5
)ther. Fee S
ifter-the-tact Investigation Fee S
TOTAL
State Surcharge: Fee S�--
Total Amount Paid to City Fee
This Pennit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
pint - t Inaits Copy Gold - Applicant's Receipt