HomeMy WebLinkAbout1984-08-20 Permit, Water Meter #7571n
CITY PERMIT NO. " 7571 •GENERAL PERMIT
CITY OF ORONO
P.O.BOX bb
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
Date
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Contractor
Owner
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City License No.State License No.
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REMARKS AND SPI CIAL CONDITIONS
PERMIT TYPE AND FEE: □ NEW □ ADDITION
^) Fee S________
□ REPAIR
Inside Plumbing ( # fixtures.
Water Meter (Sizt*^^^) Fee S.^c-cd
Remote#r, 3 S'?
Municipal Water Connection
DCopper O-----
Fee S.
Municipal Sewer Connection
□ PVC □ Cast Q
Fee S,
MWee SAC Charge-Fee S,
ACKNOWLEDGEMENT
The under&igned hereby ecknowledgcs receipt of thl* limited
permit, including accepUnce of «11 special Informitirm.
terms, conditions or requirements written shove. The
undersigned understands and rgrees under pensltv of isw
that this pennil is siricUy limtu-d In scope to the work,
activity or improvement specified; that this permit does
not grant any aulhontv to do work or acUviUes requiring
separate permit approvals; and that this pennit does not
grant authority to violate any provision of any City
ordinance or State law. rule or regulation. AU work sliall be
done In strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
tubiect to inspection, approval or reiection by the Citj .
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of Applic
On Site Septic System Fee
Water Well Fee
Mechanical Ei|uipment Fee
Moving/Lifting Buildings Fee
Land Alteration (Excavation.
Grading. Filling, etc.)
Fee
Othi'r*Fee
After-the-fact Investigation Fee
TOTAL
State Surdturge:Fee
Total .Amount Paid to City Fee W-.
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Otlicial.
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Code White I i!v* Copy Canary lnvpeciui*s Copy Pink HnanccCopy C.old Applicant’s Receipt