HomeMy WebLinkAbout1985-06-02 Permit, Water hookup #7771GENERAL PERMIT
CITY OF ORONO
CITY PERMIT NO.7771
P.O.BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
Date
Owner "T t in )C /Address -j< ,j (JL ^0 i; ^-/ ■ T^f J
Jt r\^Contractor .
City License No--------------^
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State License No.
REMARKS AND SPECIAL CONDITIONS
V^c<~ k ■7f-.4 0
PERMIT TYPE AND FFR:
Inside Plumbing (Iflxtutes ----)
ft NEW □ ADDITION □ REPAIR
Fee S
Water Meter (Size/o'
Melerf
Remote *
Fee ^ OC
Municipal Water Connection
Dcopper rn
Fee S
Municipal Sewer Connection
□ pVC Dcast Q
MWee SAC Charge
Fee S
On Site Septic System
Fee $-
Fee $_
Water Well
Meclianual Equipment
Moving /I itting Buildings
Land Alteration (Excavation,
Grading. Filling, etc.)
Fee S-
Fee S_
Fee S_
Fee S_
Fire
Sprinkler System (Fw)
Other;_____________
Fee S,
Fee $
After-the-fact Investigation
Fee $_
Fee S__
ACKNOWLEDGEMENT
Th« MnetrW—#4 Mnkv acknowMaH iM*v. of IMa ltaHa4
aaialt. taclw4ki4 ataaeiaaca a* 41 leaatil MtaMattaa.
laoM. cosilttaAa at la ^ilia iflt »4Hw ahoaa. TWa
irni—*■-— Uit4»rtMi4i M4 tpaoa aMtor paMltv ol Uar
lhat ao* etfinu U Mtadt kMia ak !• mof* W «M woth.
acttvily at tmetoataiH iptaW ti; Ibal 44t ptnaW 4oaa
4M fpaal a«» tMaotia to 4a oratk ot actMMoa ttkoMat
a»4Matt MilBit a 44»a»4«; 0*4 Mat 44t vamu 4oat aol
grant tM*<Hltr to ttotera mr ptowMoa al any City
atatitanct ot Stata Ittt. raia at ragiilaltaa. A4 wotk *a« ha
4om tai tMct cMpHoiMa itMk 41 CHt itHara m. hiill4las
eo4n Mi4/ot ha4«b 4urafi «t tagiilaMaat. ts4 4i4l ha
MMatt to kiigatgan. tgptaa4 at rat a egao hv *t Cttv.
Srhan tyat to at4tta4, 4w Mg4tralvta4 affaaa to conatt
•ay wotk foM4 la ha M Halagoa a* 4m «o«4IMa«a al
gritaataiU.
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S_____
Fee t ^
This permit is not valid until the proper fee it paid a«d
it U approved by an authorized City OfTicial.
Sigm^MC of Applicant^ __ _ j
<( vr'ivw
( Signature of City Official
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