HomeMy WebLinkAbout07-14-1987 Permit, Sewer Repair #9120GENERAL PERMIT
CITY OF ORONO
10. Box 66
CRYSTAL BAY. MINNESOTA 55323
(612) 473-7357
Owner
Contractor ( ✓ / ✓!�- E'er
City License No.11
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT N? 9120
Date tP-7
Address L�(.� 0 62 ld u t' to 2
Q*
Address
City
PERMIT TYPE AND FEE: D NEW 0 ADDITION 0 REPAIR 0 REMODEL
Inside Plumbing (NGxtures )
Water Meter (Size )
Meter H
Remote b
Fee S
Fee S
Municipal Water Connection Fee S
O Copper 0
Municipal Sewer Connection
xPVC O Cast O
MWCC SAC Charge
On Site Spetic System
ACKNOWLEDGEMENT
Fee S>3y)•OV
Fee S
Fee S
'nM untimignd beaky ackrrrukdgss utdrot of this limited permit.
irw1oding amcptarac trf all six1131 information, tants, amditiom tit
rrqulrrments w6nen above. The undenigncd underwnds and agrees
under prnahy of lass ttut this permit is %trial y limited in sasR to the "wk.
actisity tN imprrnrment specirral: that this permit drt+ not grant any
authority todouotkoraetisiticsrrgWdngselumtc lrrmitapprosaleand
that this permit da-. not grant authority to siob tc any prosi%ion (fany City
onlirurme or Statc law. rulcor rcrib, on. All uork shall be d.+ne in strict
omtplurrce with all City onlinarts. bttilding esxim aml/or health
depanment reguladom and slull be subject to impection. approsal or
rejcohm by the City. Whencsrr At otdend. the undersigned agrscs to
cortat any work fount to be in %ioUtion tithe amdidom tdthi, permit.
Si ate of Appli nI
2Z I Z .
Water Well
Mechanical Equipment
Fireplace/Wood Stove
Moving/Lifting Buildings
land Alteration (Excavation,
Grading, Filling, etc.)
Design Review
Fire
Sprinkler System (Fire)
Other.
After -the -fact Investigation
TOTAL
State Surcharge.
Total Amount Paid to City
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S 5-07
Fee S —
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
Sijna u • of City Official
• �D`
Cote: Whhe—talc Copy Canary—Impectors Copy fink—Finatim Copy cow --Appliances Receipt