HomeMy WebLinkAbout1982-10-06 Permit, Septic System #6838GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY. MINNESOTA 55323
CITY PERMIT NO. " 6838 •
(03r (o.Date
Owner
Contractor
City License No.
(612)473-7351_,^
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Sl3ii <naAddress
Address fijAPie
State License No__________________________________
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE:
Inside Plumbing ( # Fixtures.
Water Meter (Size____)
Meter #__________
NEW □ ADDITION
Fee S_______
Fee $_______f
Remote #
Municipal Water Connection Fee $.
-opper
Municipal Sewer Connection
□ pVC DCast n.
Fee $.
MWCCSACCltarge Fee $.
□ REPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee S^^/ilCL
Fee S_________
Fee $_________
Fee $--------------
Fee $_________
Other:.
Afte^the-ract Investigation
Fee S.
Fee $.
ACKNOWLEDGEMENT
T1i« uadtfiiiDcd hmby «diaowlid«Bs rvctipl of thli UmlUd
ptmill. Including acccpUnco of an ipocUl Infonnation,
lanna, condlliooa or raqulianatila wdttan above. The
undenUnda and affats under penally of law
that thia permit U ftrlcUy limilad In aeope to the worlc,
acIMly or fa»!«rovtmtnt 9ocUlad: that Ihla pctmli doea
not pant any authoHty to do week or acdvltlaa ra^ilfing
aaparala permit approvals; and that this peiroit done not
grant authodty to violaU any provision of any City
ovtMaance or SUta law, rule or regulallon. AH work AaD be
done In ttrtet compliance with all Clly ordinaneaa, building
codes and/or health department legulallona, and ahall be
aubjeet to inspection, approval lelecllon by the City.
Whenever so ordered, the undeaigned agrees to correct
any work found to be In vtoiauon of the condltioiis of
this permit.
Signature of Applicaot
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $.,St>
Fee
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
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Code; Whlle-I Ue Copy Canary-Inspector'! Copy Plnk-i'inance Copy Gold-Appikani't Receipt