HomeMy WebLinkAbout1986-01-13 Permit, City Sewer ConnectGENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
CITY PERMIT NO. 8291
Date 1-13 - 3 t0
Owner rrn'_1Lf Address
Contractor ) ' 4-) Address ('( )a;:t4 Z et ta�
City License No. a() Y State License No,
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION
Inside Plumbing (#fixtures_) Fee S
Water Meter (Size—) Fee S _ _-
Meter#
Remote #
Municipal Water Connection Fee S
❑Copper ri
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast El_
S,L
MWCC SAC Charge Fee S-,---
—_
On Site Septic System
ACKNOWLEDGEMENT
Fee
The undersigned hereby acknowledges receipt of this limited
permit. including acceptance of as gecial Information.
Meme, conditions or requirements wtitten above. The
undersigned understands and agrees under penalty, of law
that title penult Is strictly limited In seops to the work.
activity or bnptowment epeoiflad: that thls penult does
not t➢ant any suthorib to do work or activities requiring
Operate permit *Spruvals; and that this Permit does slot
greet authority to violate 0y Provision ON any City
ordinance or Slate law, rule or ngulstion. AS work @ball be
done In stalet compliance with all City ordinances. bull&"
codas and/or health dePaelment regulations, and @ball be
subAcl to Inspection, approval or raisetion by the City.
Whenever an ordered. the undersigned agmas to correct
any work found to be In violation of the conditions of
this penult.
❑ REPAIR
Iter Well
xhanical Equipment
wing /Lifting Buildings
nd Alteration (Excavation,
Grading, Filling, etc.)
re
rinkler System (Fire)
Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee
S
Fee
S
Fee
S
Fee
S
Fee S
Fee S
Fee S I
Fee S.1
Fee S - IS- G
Fee SSD S <7)
This permit is not valid until the proper fee is paid and I
it is approved by an authorized City Official.
City
Code: White—Fac Copy Canary-- Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt