HomeMy WebLinkAbout1982-09-01 Permit, Water Meter #6791CGENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOJ*oT23
A, (612) 473-N1
Owner
e
Contractor
City License No.
�tyQr� Address
_0" • Address
REMARKS AND SPECIAL. CONDITIONS
PERMIT TYPE AND Fh:E--.: Q(J NEW El ADDITION
Inside Plumbing ( # fixtures , I` Fee S
Water Meter (Sized Fee S-EaLS��
Meter # 3olQ 3L-2gL
Remote # /an35'el77
Municipal WiterConnection Fee S
❑Copper ❑
Municipal Sewer Connection Fee S
❑ PVC ❑ cast Q_
MWC'(' SA(' ('harge Fee S_
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special information,
terms, conditions or requirements written above. The
undersigned undemtands and agrees under penalty of law
that this permit is strictly Limited in scope to the work,
activity or improvement specified, that this permit does
not grant any authority to do work or activities requiring
separate pemiil appru%als: and that this permit does not
grant authority to violate any Provision of anv City
ordinance or Stale law, rule or regulation. .Ali work shall be
dome in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
subject to inspection, appy val or rejection by the City.
Whenever so ordered, the undersigned agrees in correct
any work found to he in cuilation of the conditions of
this permit.
Signatue of Applin n----._---
(utak Whit- I de ('opy Canary Intpet tot's (opy
CITY PE-RNIIT NO. 6791
Date -- q--1 —
State License No.
❑ REPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Other:
After -the -fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S
Fee $
Fee $
Fee $
Fee S
Fee $
Fee S
Fee $
Fee 5 7560
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Pink I dunce ( op5 f,uid Appitt,tni'v Receipt