HomeMy WebLinkAbout1985-03-05 Permit, New Water Well #7827GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY. .MINNESOTA 55323
(612)473-7357
Owner./{'r/ A / t:
Contractor.ISA n rirJc.A
City License 7^
REMARKS AND SPECIAL CONDITIONS
I\ 1(0(* (K 4 (4 c
CITY PERMIT NO.7827
Date.
Address
Address
State License No.
mP(
lo-C Ck p)pr<T:ii fe c i L:> ci ~T''?r ctl
PERMIT TYPE AND FI E:
Inside Plumbing (#fixtua‘s__)
)
'^NEW □ ADDITION □ REPAIR
Water Meter (Size
Meter#___
Remote
Municipal Water Connection
n Copper n
Municipal Sewer Connection
□ pvc Dcas* □.
MW( C SAC Charge
On Site Septic System
Fee S Water Well Fee
Me.hanical Fquipment Fee
Moving /Lilting Buildingn Fee
Land Alteration (Excavation. Fee
Grading. Filling, etc.)
Fire Fee
Fee S
C
Fee S _
■Sprinkler System (Fire) Fee
Other; Fee
After-lhc-fact Investigation Fee1 ee S 1
ACKNOWLEDCLMENT
Th* und#ria«n#d hervby •rkncmlediM r*c»lpt of Uilt Umiud
pennlU mdudlng accoptaAc* of all 9adaJ Information,
ftrrot, condlUoni or raqutramanta wdttan al>o%a. Tlia
undardgnad undrtaUndi and agrart undar paaaltt of taw
thmi thla pamill U ttrietly Umllad In mopa to lha work,
activity or tinpruvamant pacified: Uiat thia parmit does
not grant any authority to do work or acti«iUat raquiring
aaparala permit approvab; and that thk permit do« not
grant authoHty to vioUta any provtMon of any Oly
ortUnanra or SUta law, rule or regulation. All work diaXl be
done in etnet ctJtnpUance with all City ordinancee. building
codes andyor baalth dapartment regulations, and shall ba
mblert to intpaction. approval or ralactlon by the City.
Whanavar m ordarad. the undarslgnad agrees to rorrarl
any work found to ba in «1olaUf»n of the conditiom of
this permit.
Signature of Applicant
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S r
Fee 5 30- SO
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Offieial.
Signature of City Of^cial
Codc V^lthe lUcCopy Tanary lntp«ctor*i Copy Pink I inance Copy Gt^d-AppUctnCi Receipt