HomeMy WebLinkAbout1986-04-23 Permit, Water & Sewer Connection #8437GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
CITY PERMIT NO.8437
Date
Owner
Contra»J
City License No.
ic.t n.'h.vj ^^alA'AinrA
fen pTti^
Address ICS^•
Address 7^^ ^ ^ ^
State License No.
REMARKS AND SPECIAL CONDITIONS
'p>^>cl p^/'/hJ^'SOS
PERMIT TYPE AND FEE: J&^^EW □ ADDITION □ REPAIR
Inside Plumbing (jltixtures__)
Water Meter <Si/e__i
Meter#___________
Fee S
Fee S
Remote #
Municipal Water Connection
Dcopper Q------
Fee $3?.o<^
Municipal Sewer Connection
□ pV( DCast Q
MWeX' SAC C harne
On Site Septic System
Fee $3CL oO
Fee S
Fee $.
Water Well
Mechanical Equipment
Moving ''Lifting Buildings
Land Alteration (Excavation,
Grading. Filling, etc.)
I ire
Sprinkler System (Firei
Other; _____________
After-the-fact Investigation
Fee S
Fee $
Fee $
Fee $.
Fee S
Fee S
Fee S
Fee $
ACKNOWLEDGEMENT
TIm uAfltfiliiitd lim^ acknowititeN ncclpi ol ilUt Umii04
teimil, incliitec aeMplMie* «l aD tolofiBa#Mi,
Mrjma. e«a4lli0aa or io^oImhmiIb wiittMi alNivc, TIm
iMi4ofiifM4 oniantoiidB mm4 atrni oMlat p—aity of low
ttot 0IU poiVRit it taiM io BBopo to wadi«
icfivlfir or ipiprov«fii«fii ^octflnl; iuii fliit ponoit 4am
■ <j| ifipit my oupioriiy to 4q worit or octi«iliM roooirlog
iPfifolo pvrmif «ppro%«|o; iM iMt Mi ponoit Mm mot
iNPt iutlionty to %iotolt tm9 pro«i#oo of apy dtp
orMiwutr Of tvtofe low, rul# or ropaloHoo. Afl woiii MA bo
iaPt In firw ( wttti Hi City orfteoocoo. bniiitiog
f##M oM/<»f ip*oMb Mportfliowt lopiHo'ioMi. owi Mfl bo
•MUoct to bMpoepow, «tPro«ai or wii^tloA by M Oiy.
Wboiitrvoff i<* rifMloC M* ooioffBlgiit# jprtii lo rnawrl
any wrH% f(*un4 b» bo bi Hobiboo of M eoo#^TH of
Pili pcpfftlt.
Sign^^re^if Apj^Iicbnl
TOTAL
State Surcharge Fee S /.
Total Amounl Paid to CiD'. /r 7T
This permit is not valid until the proper fee b paid and
it is approved by an authurued City OfTtvial.
Sig^ture of City Official ^----..
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