HomeMy WebLinkAbout1987-07-02 Permit, Water Meter #9093r
GENERAL PERMIT
CITY OF ORONO
an PI RMiT N9 9093
PO. BOX 66
CRYSTAL BAY. MINNF.SOIA 55.^23
(612)473-7357
Dale
Owner OA^')/i rl^s
Contractor _L U )>i )Vt.av^ V^-c.
Cilv Uccasc No./ ..t). I /O
AddaNs
Address
Cilv __^■\. (f r \
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing (^fixtures
Water Meter (Si/e ^fe)
□ NEW
Fee S
□ ADDITION □ RO’AIR
Meter K Cp I ^4 L
Fee $
Remote(< C2l
Municipal Witer Connectiem
□ Copper □___________
oo
Ftv $
Municipal Sewer Connection
□ PVC □ Cast □
MWee SAC Charge
On Site Spetic S\Mem
Fee $
Fee $
Fee $
REMODEL
Water Well Fee S
Mechanical Lquipment Fee $
Fia*place/Wixxl Sieve Fee $
Moving/Lifting Buildings Fee $
Land Alteration (Excavation.
Grading. Filling, etc.)
IX'sign Review
Fee S
Fee S
Tin*F«»f %
Sprinkler System (Fire)Fee $
OtlxT Fm» t
After-the-fact invesugation Fee $
r.
ACKNOWI EDC.FMENT TOTAL
State Surcharge;Fee S
rhe urktcTMirneil htTi*h\ aiknimkxlgr« rriTipi <»( Ihb limitril prrmii
irKtintif^ aixvpLiiKc «*f alt infornuiiim. terms. oHiditioiis «*t
rcquircmciiis \%nllen jiK*u ’ The uixkrsi^ned umkrsumK and ainco
under pnuilu ti law that ihisfvrmitisMrKlU limiird inwofvktihc wihK.
aiti\it\ <w tmprosrmml s|«\irM\i ihai ihrs prnmt divs nm gram an\
aulhttnl> indttwitrk or adiuiirs m|uiring << (larali* ^fmilapprovaK .ind
that this fvnnifdrrsni^ grant authonlY towibie an\ prt«\ivoniiran\ (it\
iifdinani.r (K Siak* law. ruk tw a*gutiiM«t .All work shall K* ikme in sim.t
iimiplianLr with all Citv iwiiinamvs Nalding i*Kk*s ami ih health
ilcpartmcTN rrgiibtions. and shall hr si#i|c\i to insptMion. .ipproxal or
rrpMion h\ thr* C*ils UhcncscT yt ord<*rt\I. the undsrsigncd ignvs to
ioriivl am work tinind ti>K* in \u4alion of the condilums o( this )<’rmit
Ibtal Amount l^id to City Fee $
JSLoc
<uc H~t OS
This permit is not \alid until the proper Tee is paid and it is ap|
by an authorized City Official.
Signature of Applicant
Signature ol ( it)jQfficial .
t-t ^ Cj^
Cikk* WhiU* hk ('opN (anar> lnspi\iof\ Cop\l*ink I markr (*op\Gold zApplK^ni's Rcvvipi