HomeMy WebLinkAbout1986-11-10 Permit, New Water Well #8781E
GENERAL PERMIT
CITY OF ORONO
PO. BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612) 473-7357
Owner
Contractor -ae
City boense No. I `,
REMARKS AND SPECIAL CONDITIONS
-1:-x i
CITY PERMIT N? 8781
Date -- _ ll o
Address ' —�'/ 0 /
Addrem- — 1
City
PERMIT TYPE AND FEE )6 NEW O ADDITION
Inside Plumbing (fixtures )
Fee 5
Water Meter (Sine )
F.Ve S
Meter #
Remote hi—
Municipal Water ConneLtion
Fee S
❑ Capper ❑
Municipal Sewer Connection
Fee S
❑ PVC O Cast O
MWCC SAC Charge Fee S
On Site Spetw System Fee S
ACKNOWLEDGEMENT
lite urkl"ned hertbt ackrm -AWM rarq+t of thr, lunued riermil.
irOudrng aarrNarkc .d all .potvl mlorrttauon. termw o•ndtm-m tr
requirement% untt•n ahne The unrlr•ntgrkd undcr4ands and Agire•
under Renal" of law that tht, rwrmu t. ark.tlr Irmord m -wort• b• thr Nur►.
at11%11% tr tmrxutrnknt %rtetfrth, that tht� rtermn drt� rk4 Frtnt an)
au0kvn1% it, do Ntrk rk acrotic+reywnnrt rrwrate (xrmu aprruk:rk and
thaIIN% permit dot. ntgk
grantauthont%.%udalram prort.ronufan%Cu%
ordrrrrwc or tick• law. r uk rr rrguhruon All v.tkk Dull R• dtnk to .tn t
armplmme Nuh all l w onhnarkt� building otkY And of health
dernnment regulaturr.. and •hall be .uhrttl in tmrwoon. approral t••
intron M N- Co W'hencte, w, ordered. the and r.rgrk-d agrm, to
corrcrt am wtak I.,urtl to1+r m tk 1au.rt.J Ik umrlmom.d thr. rwrmtt
Water Well
r
O REPAIR
Mechanical Equipment
Fireplace/ Wood Stove
Moving/Lifting Buildings
Land Alteration (Excavation.
Grading, Filling. etc.)
Design Review
I -2f"
Sprinkler System (Fire)
Other.
After -the -fact Investigation
0
❑ REMODEL
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
TOTAL
State Surcharge: Fee S
Total Amount Paid to City Fee S i�
Thi,, fx rmit 1s not %slid until the proper fee is paid and it is appro%ed
M an authonied ('its Official.
Stgnalu ' of A , runt
Signature of Cite Official
('tile W hue Mk• Co fn C 8rtar% In%p&-i(w'c Cop% Pink- t•inana• l -p% ' iokl Aprtltutnt'� Recerpl