HomeMy WebLinkAbout1986-05-07 Permit, Sewer Connect #8456GENERAL PERMIT CITYPFRMITNO. 8456
CITY OF ORONO Date_ -L
P.O.BOX 66
CRYSTAL DAY, MINNESOTA 55?'?
(61:)473-'357/
Owner CrL)h / T e Address ld Lv
Contractor/ t If lit /'►'1 bl rl a— Address-UW
City License No.— State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing Ofixtures_I
Water Meter (Size
%leter/
Rentote ti
❑ NEW ❑ ADDITION ❑ REPAIR
Fee S Water Well
Fee S Mechanical Equlpnlrnt
Lifting Buildings
Land Alteration (Excavation.
%tunicipul Water Connection Fee S— _-- — --- Grading. Filling. etc.)
❑copper f7
3(J,(fL1
Municipal Sewer Connection Fee S Fire
__
❑ PV(c
MWCC SAC Charge Fee S -
On Site Septa: System Fee S-
---Fe
ACKNOWLEDGEMENT
The undrrsigned berths aeknurledser rtcelpt of thi Limited
permit. meluding aeeeptaner ., •1 speual inlormaUon,
tortes, conditions o, requ.-•ments rntters abuse, rhe
undersigned understands and as.— under Penalls of lar
thatthis P"mill is strictly bmll" .n —l's to the cork.
.c Us l is or Zpn.sement speelfled: fat this Perron due•
_t grant any authorin to do nark a-IUIIUes rtqulrtng
sepuste Permit apprusals. and that thu permit does not
pant authority U, Notate any prostsion of a $ City
ordinancr or State carr. Nle or regulation. All rock shall be
dune in strict ci mplianre with all ('ite ordinances, budding
,odes andlor health &,," ,rent regulauons, and shall be
sub:ct to Inspection. approsal or rtKe Unn by the Cith.
When— ndr"4. the undersigned agree. t. carrel
an' work f—rid to be In %1,Aab.m of the cond,tlans of
thl. permU-
Signa, n Applicant
rinkler System (Fire)
her:
ter -the -fact Investigation
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Fre S
Fee S
Fee S
Fre S
Slaty Sur,:bu-rge: Fee S r �V
Total Amount Paid to City Fee S ). SI)
T[uti pennit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of Citv Offl I
c.&. white --F(k Copy Canary Inspector's COPY Pink I mane C .p Gold Applicant's Receipt