HomeMy WebLinkAbout1986-06-10 Permit, Sewer Connect #8511GENERAL PERMIT
CITY PERMIT NO. 8511
CITY OF ORONO
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner Q- Address �� L%
Contractor' V Address
City License No. zsw/ State License No.
REMARKS AND SPECIAL CONDITIONS
< 7 IA c /l c ( Gr L't,
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures_)
Water Meter (Size
Meter# _
Remote #_
❑ NEW
Fee S
❑ ADDITION ❑ REPAIR
r Well
Fee S --- _--- IMechanical Equipment
Municipal Water Connection Fee
❑Copper ❑
Multici al Sewer Connection Fee S'-
VC ❑ Cast F1
MWCC SAC Charge Fee S
On Site Septic System
ACKNOWLEDGEMENT
Fee
The undersigned hereby acknowledges receipt of this Unified
permit. including acceptance of ell special Information,
terms, conditions of requirements written above. The
undersigned unckntands and agrees under penalty of law
that Nis permit is strictly limited in rope to the work,
activity or improvement specified: that this peraell don
not grant any authority to do work or activities requiring
aepante permit approvals: and that this permit does not
grant authority to violate any provision of any City
ordinance Of State law, rule or regulation, All work shall be
done in strkt compUance with AN City ordinances, building
cocks and/or health department regulations, and shelf be
subject to hupection, approval or reaction by the City.
Whenever so ordered, the undersigned agrees to comet
MY work found to be in violation of the conditions of
Nu permit.
/Lifting Buildings
ind Alteration (Excavation,
Grading, Filling, etc.)
rinkler System (Fire)
fter-the-fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee
S
Fee
S
Fee
S
Fee
S
Fee S
Fee S
Fee S
Fee S
Fee
Fee
S
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature-gKity Official
Code. White -File Copy Canary 161vpector's Copy Pink -1 inance Copy Gold -Applicant's Receipt
(,