HomeMy WebLinkAbout1986-06-02 Permit, SAC #8496GENERAL PERMIT
CITY PERMIT NO. 8496
CITY OF ORONO
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner — ]CYc e :ZDo Address /__73 /<7.1) '_ lClZe�Y� /�1-D
Contractor Address
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION
Inside Plumbing Qfixtures_)
Water Meter (Size—)
Meter#
Remote
Fee S
Fee S
Municipal Water Connection Fee S _
❑Copper ❑
Municipal Sewer Connection Fee S _
❑ PVC ❑ Cast
MWCC SAC Charge Fee S _
On Site Septic System
ACKNOWLEDGEMENT
Fee S
The undersigned hereby acknowledges receipt of" limited
permit. Including acceptance of all special Information.
terms, conditions or requirements written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited in scope to the work.
activity or knprorement specified: that this parsnit don
not grant any authority to do work or activities requtrhy
"Parsee permit approval: and that this Parrott don not
grant authority to violate my provision of my city
ordinance or State law. rule or regulation. All work sbaa be
time in strict compliance with all City ordinances. budding
codes and/or health department regulations, and sbsa be
subleet to Inspection. approval or rejection by the City.
Whenever so ordered. the undersigned ages to correct
MY fork found to be in violation of the conditions of
this Petrels.
Signature of Applicant
Code. %hire File Copy Canary -Inspector's Copy
State License No.
❑ REPAIR
ter Well
anical Equipment
/Lifting Buildings
ind Alteration (Excavation.
Grading, Filling, etc.)
rinkler System (Fire)
Investigation
TOTAL
Fee S
Fee S
Fee $ 1
Fee $
Fee S
Fee S
Fee S
Fee S
State Surcharge: Fee S
Total Amount Paid to City Fee S-V�
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signet of City Icial ,
Gold -Applicant's Receipt