HomeMy WebLinkAbout1985-07-17 Permit, New Septic System #7992GENERAL PERMIT
CITY OF ORONO
CITY PERMIT NO.7992
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-73? 7
Date
Owner
Contractor
Address
City License No.-it- tSio-r.9
Address ^ \ 0 f (~^Ji
State License No.
REMARKS AND SPECIAL CONDITIONS
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hiCf'^x'f Xliytr-k (^oa^^-lrk b£.Q -
PERMIT TYPE AND FEE: “^NEW □ ADDITION □ REPAIR
Inside Plumbing, (#fixtures
-)Water Meter (Size
Meter#___
Fee S
Fee S
Water Well
.^Mechanical Equipment
Remote #,
Municipal Water Connection
D Copper n
Municipal Sewer Connection
□ PVC □ Cast
MWee SAC Charge
On Site Septic System
Movina^iftin^Buildings^^
d Alteratji^ (ExcayaAon,
Fee $
Fee $
Fee S
Fee $
Sprinkler S)^^m (Fi
Other:
After-the-fact Investigation
ACKNOWLEDGEMENT
Tht uiMtoralcned hereby acknowltdiM rMttpt of tlU« Uiallod
pomit, deluding acotptiMict of iO tafomigllofi,
toimB, condllloiit or io«ulmiii«kU wdUon abovt. Tbo
undonignod imdtnteiidB aad aipMt itadar panalty of law
liiat Ibis parmit la ttrictty llmltad In aeopa to Iba woik.
activity or bnprovamaiit 9aciflad: IlMt UMb pacnlt doac
pot grant any audioilty to do worii or activltiaa rapiilaipg
•aparaU parmit approvals; and that this pamait doaa not
pant authority to violate any provtelQn of any City
ocdinanca or State law, rula or raguiatton. All woch diall ba
dona in atrict eompUanca with all City ordinanoaa, building
codaa and/or haallh dapartmant rapulahona. and ahdi ba
aublact to Inapaetlon, approval or lalaatlon by lha aty.
Whanavar to ordarad, Pte undaralgnad agteM to eoaraat
any worb found to ba in violation of lha eondIPona of
Ihia paimit.
Signature Applicant m /
'll:
i
TOTAL M >: .
State Surcharge:
Total Amount Paid to City
Fee S
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Fee i '7^- ^
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatiye of City (^icial
( oda Utiitc I Ua Copy Canary ~hiapoctof*s Copy Ptnl-Flllaiicc Copy Gold- AppMcgnt*! Mcoipt