HomeMy WebLinkAbout1984-08-01 Permit, New Septic SystemGENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473^357
CITY PI RMIT NO. 7547 '
Date
Owner
Contractor
Address
Adda’ss
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City License No
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State License No___________________________________
RI MARKS AND SPI CIAI. CONDITIONS
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PERMIT TYPt AND FI L: □ NEW □ ADDITION □ REPAIR
Inside Pluinbiny ( 0 fixtua*s.Fee S.
Water Meter (Si^e.
Meter 0__
l ee S.
Remote #
Municipal Water Connection
D Copper n
Fee S.
Municipal Sewer Connection
□ PVC □ Cast Q
Fee S.
MWCC' SAC Cliai^c Fee $.
On Site Septic System Fee 5 nS.Cd
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
(irading. Filling, etc.)
Fee $.
Fee S
Fee $
Fee S
Other:.
After-the-fact Investigation
Fee S
fee S
ACKNOWLEDGEMENT
Th« un«l«rticn#d hereby Avknoii!•<!•»• r«c«ipt of this lifiuud
i»wffnit. mcludmi arc^ptoftre of all ipactaJ infurmatton,
tanat, ctafidltton* or paqulramanls wntian abo%«. Th«
undarH^ad undrnitandi and agraat uodar panaltv of law
iKat tlila parmlt is ttrtctly bmitad In acopa Ui tlia work.
acU^ltv ur lBipf«nafiiant upaeifWd. (hal Him panmi doaa
nul pnwai ant aalkwcai* iu tki wugk ut akUvilMr* »*(«aArlac
aaparaU patwu apprwaU. and tluii thia pamit duaa not
grant awtlMicity lo violate any pruvtaUra oi any City
or stato law, ruia or raguiaUun. All work diaB ba
In atHct cnrapftlanre wifk all Uty urdinancaa. braiding
•nd/nr baallb dapavfraant regulatlona. and tkatt be
aablact tn tnagactUin, approval or ftiacdon by tka City.
Wkancya# ao ufdaaad, ika ondanigiiad agraaa to cocrcct
any wodi iownd to kt in vtedadon of Ika eondiUoAi uf
tduapagrait.
TOTAL
State Surcharge:Fee S
lotjl Amount Paid to City Fee S
This pcmiit is not valid until the proper fee is paid and
it is approved by an aulhonzcd C ity Offtcial.
Si^na&are of City Official
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