HomeMy WebLinkAbout1985-07-15 Permit, New Water Well #7988GENERAL PERMIT
CITY OF ORONO
CITY PERMIT NO.
P.O.BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
7988
Date /«/y 1
Owner ■-r.tAA 03sj4c>rl
Contractor
City License No—^PPiif^.4—
Address ////■■g //, A^L
Address CO . g?
State License No.----------------------------------
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: NEW □ ADDITION □ REPAIR
Inside Plumbing (#nxtua-s—)
Water Meter (Si/.e----)
Meter# _______
Remote #.
Municipal Water Connection
OCopper Q------
Municipal Sewer Connection
□ PVC □ Cast Q.
MWee SAC Charge
On Site Septic System
Fff ^Water Well
dcchanical Equipment
Moving /Lifting Buildings Fee
Land Alteration (Excavation, Fee
Grading. Filling, etc.)
Fire-----------------------------------------
Fee ^
Fee «
Fee S---------------
Fee 5
Sprinkler System (Fire) Fet*
nthiT- Fee
Fee S After-thc-fact Investigation Fee
'Xo.oo
ACKNOWLEDGEMENT
The und«niitied hewby •cknemUdgei receipt of ihU Umiud
poimlU Includim iccopunc* of aU ipacial informaU^,
teRDt« coiiAtiofia or raguiiemtou wdiun abovt. The
undenisntd undanUndi and afraw undar panaJiy of Uw
that thia pannll la atilctlir Uintud in acopa lo the work,
acUvity or Iniprovamant ipaclflad; that Ihla parnilt doaa
not ixmnt any authortty to do work or activiUaa raquiiing
■eparata parmlt appro%*ala; and that thla parmlt doaa not
grant authoiity to violate any provition of any City
ordinaAca or SUte Uw. ruU or raguUtion. AQ work ahaU b#
dona In atrict compUanca with all City ordinancas. building
codaa and/or haalth dapartmant raguUtlona. and ahaU ba
aubiact to InapacUon. approval or ralactlon by tha Oty.
Whanavar ao ordarad, tha undaraignad agraaa to corract
any work found to ba In %ioUtlon of tha conditloni of
thia pvnnit
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $----—
Fee %3>(S'^0
This pennit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
Code: White-nie Copy C»n«iy-ln*pector'» Copy Pink-Flnwtce Copy Cold-Appllcwfi Receipt