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HomeMy WebLinkAbout1985-10-24 Permit, New Septic System #8142GENERAL PERMIT CITY OF ORONO P.O.BOX 66 CRYSTAL BAY, MINNESOTA 55323 (612)473-7357 Owner ~ CITY PERMIT NO.8142 Date Address Contractor City License No. Address /^^ViLK State License No. REMARKS AND SPECIAL CONDITIONS ________^ ~/C>VO ^ /r>^X. PERMIT TYPE AND FEE: Inside Plumbing (#fixtures __) Water Meter (Size__) Meter#_____________ ja^JEW □ ADDITION □ REPAIR Remote #, Municipal Water Connection DCopper n Municipal Sewer Connection □ PVC □ Cast Q MWee SAC Charge On Site Septic System Fee S Water Well Fee Mechanical Equipment Fee Moving /Lifting Buildings Fee Land Alteration (Excavation, Fee Grading. Filling, etc.) Fire Fee Fpp $ » Fee S Fee $ Sprinkler System (Fire) Fee Other: Fee After-the-fact Investigation FeeFe. ACKNOWLEDGEM ENT Tht undtiilgMd bmby acbnowltdctt ractlpt of tbit limtud pofBiil, bMludbif occopUnc# of aO ipoeUl bifotmatfoii, toms, condltfonB or itquiftmtnU wditon abova. Tb# umiafdfiiad luidaratandi and agraaa undar panalty of law that fbla paimlt U ttrictiy Umitad In tcopa to lb# work, activity or lmprov#m#nl ip#ctfl#d; tiiat Ibla patmlt doaa nol grant any authority to do work or aetivltlaB raqulitnf aaparat# permit approval#; and that tbia permit doe# not ipant autiiorfty to violate any provltion of any City ordinance or Stale taw, rule or regulattooi. AD work abaD be done bi atiict comptianee nrltb aD City ordtaianeaa, buildini eodea and/or bealtb dapartinent ragulationa, and diaO be aubiect to Inapeetion, approval or lafectton by tbe City. Wbebever to ordered, the undeialined agiaea to correct any work found to be In violation of tbe condlttona of Ibla permit. Signature of Applicant Fee s Fee TOTAL State Surcharge: Total Amount Paid to City This permit is not valid until the proper fee is paid and < it is approved by an authorized City Official. iignatu^^^ty^^c^ Code tirhilc I lie Copy (anary - Inipector't Copy Fiftk-Hiiafica Copy Goid-AppikanCf Racaipi