HomeMy WebLinkAbout1983-06-15 Permit, Sewer & Water #7029GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
CITY PERMIT NO.”. 762^1
Dale
Owner Isvi/ccr. C.<f,Address,3/a
L^A i fe/fcfev A,ldr.-., u/. '77 g- 0/vu^Se^
City License No ________________________________ State License No ------------------------------
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE:^NEW □ ADDITION □ REPAIR
Inside Plumbing ( fixtures )Fee s._On Site Septic System Fee
Water Meter (Size t Fee $Water Well Fee
Meter #Mechanical Equipment Fee
Remote #
Municipal Water Connection
K
Fee Moving/Lifting Buildings Fee
^HCopper n------Land Alteration (Excavation.Fee
Grading. Filling, etc.)
Municip^ Sewer Connection X t*Fee % cK)
UCI DV/Z' ( 1 1 1 Other:.. - FeeJQIrVC LJvaHl
MWee SAC Charge Fee After-the-fact Investigation Fee
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ACKNOWLEDGEMENT
Th# undtnLaiicd htttby •elmawtodiM fc^lpx of this Umiud
Including occopunet of aO ipoclal Information,
UfBU, conditions or rtqulstnianu wdlUn abevt. The
undritigiitd understands md agraas under penalty of Uw
that thb permit U strlcUy IlniUad In scope to the work,
activity JT Improvemant specified; that this permit does
not grant any authority to do week or activlUas requiring
separata permit approvaU: and that thU permit does not
grant authority to vtoUU any provUlon of any City
ocdlnance o' SUte Uw, rule or rtguUUspi. All work shaD be
done In stict compliance with eU Qty ordinancea. building
codee and/or health department leguUdons, end diall be
sublect to Inapectloo, approve! or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be In vioUtlon of the conditions of
this permit.
ature of Applicant
TOTAL
State Sureharge:
Total Amount Paid to City
Fee S.
Fee S Ml
This permit is not valid until the proper lee is paid and
it is approved by an authorized City Official.
Signature of City^^
Code: White-IHe Copy Canwy-linpectnr’iCopy Pink lininceCopy (lold Applicenl'i Receipt
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