HomeMy WebLinkAbout1982-11-18 Permit, Water Meter #68811437 • 4
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GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Vril I 1 UULJJL
Date
Owner S
U/ ' Mvfc.
^________________________________City License No.
Address ^ 4/^
Address In SO ! /l/X—LS_
State License No-------
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: D NEW D ADDITION D REPAIR
Inside Plumbing ( # fixtures-----)
Water Meter (Size-^£)
Fee $On Site Septic System
Fee t -l^rQO Water Well
Meter » ?>Q ! 03 ^ —
Remote# J ^ 4"'1 L
Municip^Water Connection
Copper
Fee » Al}. (JO
Municipal Sewer Connection
□ PVC □ Cast Q
MWCC SAC Charge
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee $
Fee *
Other:,
Fee $,After-the-fact Investigation
Fee $
1 ee $
ACKNOWLEDGEMENT
HcttvlSrorlmptov«m«nt ipecift«d; that this p«mlt doM
not gfM»t M»y •uthoiKy to do work or actlvltlM nauirlng
!Lparat« ponnlt opprovolr, and that tto
awit authortty to vloUte any ptovlMon of any
^^•nce or SUta law. rule or ragulatton J4U work
In atiict compUanea with aU City ordinancaa
.tSL milo. h»l«.
Mblact to Inapaclion. approval or ralaction by tha City.
Whanavar ao ordarad. tha undaralgnad agraaa to contact
any work found to ha In vlolatfon of tha condltlona of
Ihto ptimit
Signaturcjof Applicant ^ire^f Applicant ^ -yf
Ay
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $,
Fee < ^ S.S0_
This pennit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
Code White-l ilc Copy Cwary-Inspectoi ’lCopy Pink-Finance Copy Gold Applic«.fs Receipt