HomeMy WebLinkAbout1986-05-27 Permit, Septic System #8484GENERAL PERMIT CITYPLRMIT NO. 8484'
CITY OFKORONO Date -66 j�a�i9RW,
CRYSTAL BAY, MINNESOTA 55323
(61')473.7357
Owner,,/,y� as g r Y r l L - kj Address !��s C/]�1 l / '1w jJ� r .
Contractor R[-�'��✓- Address —710CJ11/71r7s\
City License No. C` -I YL State License No. Zue- rz2
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing Ofixtures—) Fee S
Water meter (size _) Fee S
MeterN
Remote 8
Municipal Water Connection Fee S -_—
❑Copper 11
Municipal Sewer Connection Fee S ....__
❑PVC ❑Cast E-
MWCC SAC Charge Fee S
On Site Septic System Fee
ACKNOWLEDGEMENT
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tw ve.mit
Signatu �tlF'AgPlicant 1
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'moi t
Bier Well
rchanical Equipment
wing /Lifting Buildings
and Alteration (Excavation.
Grading, Filling, etc.)
IT
ainkler Syystem (Fire)
her: I& OGM
'ter -the -fact Investigation
TOTAL
Fee S
Fee S
Fee 3 -
FCC 3 -
Fee S
Fee S
Fee S /
Fee 3 -
State Surcharge: Fee S_t..Lv
Total Amount Paid to City Fee 3 (]0e's.Z
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
of City
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