HomeMy WebLinkAbout1985-12-09 Permit, Sewer Connect #8232GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) t73-7357
Owner c o
Contractor !/k�
V�
City License No. SU �
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures_)
Water Meter (Size—)
Meter#
Remote N
/
❑ NEW ❑ADD'DIIT�I�O�N
Fee S nom;%•
Fee S___ —_
Municipal Water Connection Fee S
❑Copper 0
Mutci I Sewer Connection Fee S
PVC ❑ Cast
MWCC SAC Charge Fee S _..
On Site Septic System
ACKNOWLEDGEMENT
Fee S
The undersigned hereby acknowledges reeegpt of this limited
Permit. Including sacsptanee of all special Information.
tome, eonditiope or require rents written above. The
undersigned undentands and aper under Penalty of low
that New Permit is sY/elly, limited In scope to the work.
activity v ImProvem.nt ,pried; that this Permit don
not pont any "chorda to do work or activitir requiring
separate permit approvals: and that this permit dor not
pant authority to violate My provision of any City
ordinance or State law. rule or regulation. AN work @hall be
done In efekt emoplWee with all City ordtaaner, banding
eaNs andlor bealth department repsletions, and skaa be
subject to Inspection, approval or teeetion by the City.
Whenever r ordewd. dw undersigned sprees to cornet
any work found so be In violation of the conditions of
flue permit.
CITY PERMIT NO. 81232
Date !`_9 _f/_—S
Address �f ��� &07.( Agri J5 & ' 0
1
Address �/ �<}.v rCZTC.-k'
State License No.
❑ REPAIR
ater Well
echanical Equipment
oving /Lifting Buildings
nd Alteration (Excavation,
Grading. Filling, etc.)
kler System (Fire)
r -the -fact Investigation
TOTAL
State Surcharge:
Fee S
Fee S
Fee S
Fee $ I
Fee
S
Fee
S
Fee
S
Fee
S
Fee $�
Total Amount Paid to City Fee S
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
City
Code White Idc(opy Canary Inspector's Copy pink -FklminCopy Gold - Applicant'sReampt