HomeMy WebLinkAbout1985-08-16 Permit, Sewer Connect #8043GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
CrTY PERMIT NO.8043
Date !6,
Owner,
CctnlrAclnr If ^ '
City License No._____
\J^0/\J Address ir\V~
REMARKS AND SPECIAL CONDITIONS
Address .vrWx
State License No.
PERMIT TYPE AND FEE;
Inside Plumbing (^Mixtures__)
Water Meter (Size__)
Meter#______________
Q NEW
Remote I,
Municipal Water Connection
D Copper r~l
Fee S
Fee S
Fee S.
Municipal Sewer Connection
SpVC DCast Q.
MWee SAC Charge
On Site Septic System
Fee S-
Foe It '30 00
Fee S_________
ACKNOVv LLDGEMENT
Th« underalined hereby acknow^edeti receipt of thU limited
permit. Including ecceptence of ell ipeciel information,
terme, conditlont or requirementa written above. The
underaigned undentandi and agreei under penalty of law
that thii permit is strictly Limited In scope to the work,
activity or improvement specified; lhat this permit does
not grant any authority to do work or activities requiring
separate permit approvals; and that this permit does not
grant authority to violate any provUlon of any City
ordinance or State law, rule or regulation. AO work shall be
done in strict compliance with all City ordinances, building
codes and/or health department regulatioiu, and shall be
subject to Inspection, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit
4 □ REPAIR
Water Well Fee S
Mechanical Equipment Fee S
Moving /Lifting Buildings Fee S
Land Alteration (Excavation,Fee S
Grading. Filling, etc.)
Fire Fee S
Sprinkler System (Fire)Fee S
Other:_ Fee S
After-thc-fact Investigation Fee $
TOTAL
State Surcharge:
Total Amount Paid to City Fee s“3(D.S0
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
y
Code; \^Tiitc-nic Copy Canary-lnspcctor’i Copy Pink-Hnance Copy Gold-Applicant*! Receipt