HomeMy WebLinkAbout1985-11-06 Permit, Fireplace #8169GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
CITY PERMIT NO.8169
Date
Owner
Contractor / Ka t ie
/City License No.
REMARKS AND SPECIAL CONDITIONS
Address 0 h ■
Address / 3^7S' ^JCfA Oi'e^LKd f){^<
State License No.______C _i___________
PERMIT TYPE AND FEE:
Inside Plumbing (#fixtures —)
Water Meter (Size__)
Meter#______________
□ NEW □ ADDITION □ REPAIR
Fee S
Fee S
Remote #,
Municipal Water Connection
OCopper Q____
Fee S
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Gr; ding. Filling, etc.)
Municipal Sewer Connection
□ PVC □ Cast Q
MWee SAC Charge
On Site Septic System
Fee S —
Fee S
Fee S.
Fire
Sprinkler System (Fire)
Other:_____________
After-the-fact Investigation
Fee $- - - - -
Fee
Fee $_ _ _ _ _ _
Fee S- - - - - -
Fee $_ _ _ _ _ _
Fee $_ _ _ _ _
Fee S_ _ _ _ _
Fee S_ _ _ _ _
ACKNOWLEDGEM ENT
Th® undersigned hereby acknowledges receipt of this limited
pennit, including acceptance of ail special information,
terms, conditions or requirements written above. The
underdgned rnderstands and agrees under penalty of law
that lUU permit is stricUy Umited in scope to the work,
activity or improvement specified: that this permit does
not grant any author!^ to do work or activities requiring
separate permit approvals: and that this permit does not
grant authority to violate any provision of any City
ordinance or SUte law, rule or regulation. All work shall be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
subject to inspection, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of Applicai^ ^
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $
Fee It. ^
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature^^fC/'y Officials ..
Code: Whitc-l Uc Copy CtnMy-Iinpecior't Copy Pink -t-inance Copy ild-AppUcant'i Receipt
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