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HomeMy WebLinkAbout1986-01-31 Permit, Fireplace #8321I L I GENERAL PERMIT CITY OF ORONO P.O.BOX 66 CRYSTAL BAY, MINNESOTA 55323 (612)473-7357 Owner Itth ___________ ContractorChgi 0 la ^ City License No_____------------------ REMARKS AND SPECIAL CONDITIONS _________^ A) <Lir y fi .h' ■f CITY PERMIT NO.8321 Date /- 2/- Si. Address ^ ^ C ke l. ^ lac Address ^ ^ . /yia State License No________________ PERMIT TYPE AND FEE: Inside Plumbing (#fixtures __) Water Meter (Size__) Meter# ______________ □ NEW IB^DDITION □ REPAIR Fee $ Fee S Remote #, Municipal Water Connection n Copper f~l Municipal Sewer Connection □ PVC □ Cast Q MWee SAC Charge On Site Septic System Fee S Fee S Fee S._ Fee S_ Water Well Mechanical Equipment Moving /Lifting Buildings Land Alteration (Excavation, Grading, Filling, etc.) Fire Sprinkler System (Fire) Other:.____________ After-the-fact Investigation Fee S Fee i 30 Fee $____ Fee S____ Fee S Fee S Fee S Fee S ACKNOWLEDGEMENT Th« undenisned hereby ecknowlcdgee receipt of this limited penniii Includlnt acceptance of all q>eclaJ information, ierma, conditions or requirements urdtien above. The undeieigned understands and agrees under penalty of law that this permit is strictly limited in scope to the work, acUviiy or improvement ^tcifled; that thU permit does not grant any authority to do work or activities requiring separau permit approvals; and that this permit does not grant authority to violate any provision of any City ofilinance or State law. rvile or regulation. AH work shall be done In strict compliance with all City ordinancas, building codes and/or health department regulations, and shall be sublect to inspection, approval or reiection by the City. Whenever so ordered, the underslgiied sgrsai to correct any work found in violation of the conditions ol this permit TOTAL State Surcharge: Total Amount Paid to City Fee S SO Fee This permit is not valid until the proper fee is paid and it is approved by an authorized City Official. Signature of City Official '^4^ 5r Code: Whltn -f Oe Copy Caniry-InHmctor'f Copy Fink-Fingact Copy Gold-Applkaat't Receipt