HomeMy WebLinkAbout1986-06-02 Permit, SAC #8495GENERAL PERMIT
CITY OF ORONO
Owner
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Laam-Iti l'�I'/S�fI1S�1_AJ Address
Contract...- _ __ r Address
City Licens-, '
REMAR;'`_
a
SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NE;v [I ADDITION
Inside Plumbing (#fixture• ) I-;:. � .
Water Meter (Size ) Fee S --
Meter #
Remote
Municipal Water Connection Fee S
❑ Copper ❑
Municipal Sewer Connection Fee S -. --.
D PVC DCast
MWCC SAC Charge Fee S
On Site Septic System
ACKNOWLEDGEMENT
Fee S
The undersigned hereby acknowledges receipt of this limited
permit. including acceptance of all special information.
terns, conditions or requirements wdtten above. The
undersigned understands and agrees under penalty of law
that this permit is striedy limited in scope to the work.
activity or improvement specified; that this permit does
not grant any authority to do work or activities eeauiring
separate permit approvals; and that tbis permit does not
pant authority to violate any provision of any City
ordinance or State law. rule or regulation. AU work @bail be
d%.ne in strict compliance with all City ordinances. building
codes and/or health department regulations, and shall be
subject to inspection, approval or rejection by the City.
Whenever so ordered. the undersigned ape" to correct
any work found to be in violation o* •tie conditions of
this permit.
Signa" of Applicant., //
CITY PERMIT NO. 8495
Date
State License No.
❑ REPAIR
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration ( Excavation,
Grading, Filling, etc.)
i re
rinkler Systerr, (Fire)
Fee S
Fee $
Fee $
Fee $
Fee S
Fee S
he • Fee S
fter-the-fact Investigation
TOTAL
Fee S
State Surcharge: Fee S
Total Amount Paid to City Fee S `�/� •CJU
This pennit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City
.,
Code: White - File Copy Canary -- Inspector's Copy Pink -Finance Copy Gold- Applicant's Receipt