HomeMy WebLinkAbout1986-07-01 Permit, Septic System #8547GENERAL PERMIT CITY PERMIT NO. 8547
CITY OF ORONO
P.O.BOY 66 Date
CRYSTAL BAY. MINNESOTA 5-5323
(f6�12) 473-737
Own_r.
P
1✓� Address —RU-)
Contractor t.t t ✓<t h /� J �'✓ ✓� C C' ; Address
City Uccnse No. �U 1C' State License No.
REMARKS AND SPI: CIA ISIDN DITIONS
ACKNOWLEDGEMENT
The undemgnrd hereby acknowledges receipt of this limited
permit. Including arceptai.ce of d1 spedd information.
terms, conditions or requirements written abme. The
undersigned understands and spires under penalty of law
that this permit Is strictly limited In scope to the work.
activity or Irriproyement specified; that this permit dues
not pant say authuntw to do work or scustues requiring
separate permit approvals: and that this permit don not
pant authority to sloute any proytsion of any City
urdinsnre of Slate law, rule or regulation. All work shall be
dune In strict compliance with as City ordinances, budding
codes and/nr health department regulations, and shall be
mbiect to Inspeetion. approval or reieetion by the City.
Wheneser. sit ordered, the undersigned agree to correct
any work found to b► In stolatiun of the cunditions of
this permit.
Sign (UR Of pplican
TOTAL
State Surcharge: Fee S --P -S-Z)
Total Amount Paid to City Fee S_.1. -
LP
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official _
C'odcNldte - I He Copy Canny Inw"Itil'sCopy t'Ink- IinanceCopy Gold-Applkani);ftc pt .
PERMIT TYPU AND Fl+:
NI:W
❑ ADDITION ❑ REPAIR
Inside Plumbing Wixtures_ I
Fee
Water Well
Fee S
Water Meter (Si/e
Fee
Mechanical Equipment
Fee S
!Neter N
Remote
Moving /Lifting Buildings
Fee S
Municipal Water Connection
Nee
S_.____ _.�
Lance Alteration (Excavation.
Fee S
❑Copper ❑
Grading. Filling, etc.)
Municipal Sewer Connection
Ice
S . - ---- _
Fire
Fee S
❑ PVC' ❑ (.t,t
�-
Sprinkler System (Fire)
Fee S
MN'CC' SAC Charge
F=ee
S _ _.._ _.. _
then:
Fee S
On Site Septic Sysent
1-ce
S 25'
After -the -fact Investigation
Fee S
ACKNOWLEDGEMENT
The undemgnrd hereby acknowledges receipt of this limited
permit. Including arceptai.ce of d1 spedd information.
terms, conditions or requirements written abme. The
undersigned understands and spires under penalty of law
that this permit Is strictly limited In scope to the work.
activity or Irriproyement specified; that this permit dues
not pant say authuntw to do work or scustues requiring
separate permit approvals: and that this permit don not
pant authority to sloute any proytsion of any City
urdinsnre of Slate law, rule or regulation. All work shall be
dune In strict compliance with as City ordinances, budding
codes and/nr health department regulations, and shall be
mbiect to Inspeetion. approval or reieetion by the City.
Wheneser. sit ordered, the undersigned agree to correct
any work found to b► In stolatiun of the cunditions of
this permit.
Sign (UR Of pplican
TOTAL
State Surcharge: Fee S --P -S-Z)
Total Amount Paid to City Fee S_.1. -
LP
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official _
C'odcNldte - I He Copy Canny Inw"Itil'sCopy t'Ink- IinanceCopy Gold-Applkani);ftc pt .