HomeMy WebLinkAbout1985-05-01 Permit, New Water Well #7893GENERAL PERMIT
CITY OF ORONO
Owner
P.O. BOX 66
CRYSTAL BAY, MINNESOTA 55323
(61 2) 473-7357
Contractor�`'� - )
City License No.
REMARKS AND SPECIAL CONDITIONS
Address
//Address
PERMIT TYPE AND FEF: ❑ NEW ❑ ADDITION
Inside Plumbing (#fixtures )
Water Meter (Size )
Meter#
Remote
I-ee S
Fee $ --
Municipal Water Connection Fee S _
❑ Copper n
Municipal Sewer Connection Fee S _
0 PVC ❑ Cast
MWCC SAC Charge Fee S .
On Site Septic System
ACKNOWLEDGEMENT
CITY PERMIT NO. 7893.
Date _I-- / ?�;_
State License No. _ I
0REPAIR
:iter Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration ( Excavation,
Grading. Filling, etc.)
Fee S
Fee S
Fee $
Fee S
Fire Fee S
Sprinkler System (Fire)
ther:
I'r'e g After -the -fact Investigation
The undersigned hereby acknowledges receipt of this Waited
permit. including acceptance of all pedal information.
terms. conditions or requirements wdtten above. The
undersisned understands and agrees under penalty of law
that this permit is strictly limited in scope to the work.
activity or improvement specified: that this permit does
not grant any authority to do work or activities requiring
separate permit approvals: and that this permit does not
grant ruthority to violate any provision of any City
ordinance or State law. rule or regulation. All wota @hall be
done M strict compliance with all City ordinances, building
codes and/or health department regulations. and shall be
sublect to impoedon. approval or relecticn 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 %N w^^'�••""�
TOTAL
State Surcharge -
Fee S
Fee S
Fee S
Fee S -5-0
Total Amount Paid to City Fee '
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatore of city Ofjfici
Cad White t i e Copy Canary In"- vir's Copy Pink F inance Copy Gold - Applicant's Rpt