HomeMy WebLinkAbout1984-07-12 Permit, SAC #7504GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55321
(61') 473-73 7
Owner Q • ' "'
04
Contractor
City License No
RF MARKS AND SPI CIAL CONDITIONS
CITY PERMIT NO. 75504
Dater -- I Id –94
Address — )l ✓1 �..
Address _„3&,n__ _
--- State License No. --
PERMIT TYPE. AND FEE: V-Nlt.W ❑ ADDITION
Inside Plumbing I N fixtures. 1 Fee S
Water Meter (Si e_) Fee S
Meter N
Remote N
Municipal Water Conne.ct�iica� � Fee
❑Copper ��,
Municipal Sewer Connection Fee b –A-1, L-'`
xPV_C ❑ Cast n
MWCC SAC Charge Fee SPA (l,
ACKNOWLEDC,EMENT
The uodrtvgned herebt as b. nu ledges reeelpt of this limited
pens ll, ol"t,ding accep Waw of W pedal information.
term., a.m dmons or re0uatments written slime. The
undersigned undrntands and agrees under parasols of law
that this permit I. stncdt limited In scope to the work.
avtiUti .,r unproaement specified. that that perms does
nod pent ani au Non" U, Jo work or acUsluee reyualn{
separate permit apprm also and that this permit does not
pant wdh,,ntt to aLdale ant proalsun art ans l'It,
1,rch arlre or state law, rule or regulation all wort ahaa be
done in ~1 amore ralenre wad. W fits ordp.anae. budding
codas wd,.ke health department regulation•and shall be
subject to impeauon, spproval or releeuon bt the ('Its
W"heneser w -adered. the undersigned spree. t,, ,.,ne.I
on, work found to he in ata4uon nl the undlb�.na .r
this permll
_.___-_ --( ads •1tIM -1 sir 1 (sr+) 1 anises Iny.r. L., a 1 cops
❑ REPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moiling/Lifting Buildings
Land Alteration 0 xcavation,
Grading, Filling, etc.)
Other:
After -the -tact Investigation
TOTAL.
Fee
S
Fee
S
Fee
S
Fee
S
Fee
S
Fee
S
Fee
S
Stile Surcharge Fee SJ-- e
Intal Amount Paid to City Fee S
Ihls pennil is lout valid until tha, ptuper fa t, pied end
It is approved by an authonted City Official.
SignIll t lh Office'
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