HomeMy WebLinkAbout1987-06-16 Permit, Water Well #9062GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL. BAY. MINNESOTA 55323
(612) 473-7357
Owner �'� �(C'i ►E' �C�C-P r
Con
tractor
City license No. J L
REMARKS AND SPECIAL CONDITIONS
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CITY PERMIT N? 9062
Date --
mo -f -,l
Addrt.N- % t� 0L. r r !Ic- P/Q C'--kL—
Addrem
City
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PERMIT TYPE AND FEE
Inside Plumbing (afixtures
Water Meter (Size —)
Meter a
Remote a —
Municipal Water Connection
O Copper O
Municipal Sewer Connection
❑ PVC ❑ Cast O
MWCC SAC Charge
On Site Spetic System
ACKNOWLEDGEMENT
NEW
Fee S _
Fee S
Fee S
Fee S _--
Fee S —
The uexkr4pn.d tk'n•ht acknrwkdpr. n•ctnpt t4 Ihr Irmtkd rwrmu.
inluduq aurpunr of all .Inial Inhnnuuum. Wnrnh. tortduion% tr
regtarcrtknt w ;uen at%.%c lire undermpnrd undtvanh
. and agrct,
unkr prnrltt td I -.w that thisprrmn n.trwtl% Irmtad in vola• w ilk- work.
aotu% rK rmprr-ement <prarkd: that this lx•rmtl dtxt niA grant am
emhonit dnh~r& or aaut iut•. rtgmnnp -tpualr rtermn apprmak an d
that this rwrmrtdtxr nagrartt audurntt to tmttalr ant prmwm otam ('u%
onhrunc or Stair taw rule of rrpu4rut,n All wtxk .hall tv tkmr m vn•t
romplanc wish Al ('nt ordrnartmN. hurltdtnp ctak. anti or htnhh
tkparinu•m rtpulatwnk. and %hall hr .ut+XYt to rmprltkllt..jprmal or
rrlttiutm ht itk• Co lyhtw%er v, onkred, the unirr%jo d ap it, to
t orret t :nn wurk found w to in tuJautn d thz- onduuxn of this dertntt
Signature of Applicant
,r 44-
❑ ADDITION
Water Well
❑ REPAIR
Mechanical Equipment
Fireplace/ W(ad Stove
Moving/ lifting Buildings
land Alteration ( Excavation.
Grading, Filling. etc.)
Design Review
Fire _-
Sprinkler System I Ere)
Other. —
After -the -fact Inw-stigation
TOTAL.
❑ REMODELS �,
Fee S Q
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
State Surcharge: Fee S '
Total Amount Paid to City Fee S SD
C k a 74 ; 5S
This ptrmit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
Signature of city Orr I
('retie White F&Copy Canar% In%M-tor'% ('opt Pink Finan►r Copy GO& AppAianf% Receipt