HomeMy WebLinkAbout1986-10-23 Permit, Sewer SAC #8752GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
Owrter l �< ► / ( to C'-��, 4a 11, ►moi
Contractor
City license No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE--
Inside
EE
Inside Plumbing Ofixtures
Water Meter (Size —)
Meter At
Remote 4 —
Municipal Water C'onnecuori
❑ Copper ❑
Municipal Sewer Connection
❑ PVC ❑ Cast ❑
MWCC SAC Charge
On Site Spetic System
ACKNOWLEDGEMENT
c•rn, PFRMIT N? 8752
Date —4 , , vz 3_ IL
Adores, /I 6rea),) to -x
Address
City
❑ NEW ❑ ADDITION
1 Fee S
Fee S
Fes S
Fes S
Fee S 75. tuft
Fee S
ilii• urdmr ited hrrtirt u'kw %ktlpr, rttittpt 4 thi. Itmmd permit,
intuhnp xtrptamr ,d all tpxvl mhwmah,rn, wren,. ox fitwm ,.
rryurem mr wntkn ahwr IV undervpned urdrrwrwh and akmt,
under prnaltt ,e Ww that thn pvmn r urrtlt limited to wortr ul the w ork.
atvtnt ,a tmprotrmmi yaxdad. that the. permit hx, ma print am
auth,mtt Lod,+ wtwk or alntntrn n'tlunrlp Yparar permit appro%2k. amt
that thm premn d,n ma pqm stabs nit u, ntiar am protrwrn td an, ('itt
,wdmtmvtw%laklar rule,rrepulamrn All uiNk%hallbe Ll,Mrin ami
.nmpleme with all ('u% ,rRhritmx\ hurkhryt oxk� and ,w heath
tkpanmmt njpulatrtwn, and Jell he %uhjott to rmrmtr,m. approtal on
rcjeoum ht the (',I% whent•ne, wr wderad. the umkrvpmd aprtt. to
,otn%t an\ w,Mk Lruml I-, he In 4,Jah,, n 4 the Urndtmrw of the. permit
Signature (if Applicant
Water Well
❑ REPAIR
Mechanical Fquipment
Fireplace/WmA Stove
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Design Review
Fin
Sprinkler System (Fire)
Other.
After -the -tact Investigation
TOTAL_
State Surcharge:
Total Amount Paid to City
❑ REMODEL
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
I'a s tin`
Fee S 6
Fee S (47�;.sv
i
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
Signature of ity O"
oink Whne—Fie Copy Canan In%Mux%Copy Pink-FilrroeCopy GoW Apphcani%hemp