HomeMy WebLinkAbout1986-12-30 Permit, New Water WellGENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)47.3-7357
Owner 6 JAW
Contractor
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT Tl PF. AND FEE: NEW
Inside Plumbing otfixturo, ____1 Fee S
Water Meter (Siic - -_ ) Fee S —
('11"i PFR%1lT N° 8857
Date _ � • �' �'
�a15
C-71 -7 ; 7 ,rir
Addlecc t_ /31 -OU -1A.1 lI
Address
City
O ADDrION ❑ REPAIR
Marrn ----------- -------_
__..
Remote +t -- ---- ---
Municipal Water Connection
Fee
❑ Copper O
Municipal Sewer Connection
I -Le S
❑ PVC ❑ Cast ❑
MWCC SAC Charge
Fee S
On Site Spetic System
Fee $
the undcragtnnl hrreh, ackntnvtnly% ntnpt .4 Thr, hrnneJ r%,imt.
nwmuding wrplar-e d all %Met Ink•rmttron, term,. uxtdrutrn, ra
reytrrrmema An atkyr. The urakivitrwtl undmutands and agree
under pr h t4 law that this permit is vrwdt limited in worr h, the wink.
attnns iw tmrxrnertwrtl 4wified: that thi% rx•rmn tkw+ my itranl am
atulwxitq ut tkr wink tx alYl.iuet reyunng w ryt ra x' permit apprtwak: anti
Oat this prtmMdor+,rungrandaudutntta,txdatramprovewntian;. iii
exdinence tw Slate VN ntk (v n1tutatum All r.rwk tiaU tw ekxte in arw i
ciwnplrame with all (lt} .edtrt mx%. huOJwg oxla and'ty health
derwnwnt rrgulaumx„, and 4*11 hr ruhKtt to tmpn-tion, aripmal .n
n7n-thm ht the 011 whene,rr v).ndrted. the undrrvgned aper ni
irwnCt am w ink knead u, he In tt. Jau0rat ti the t ,xxhtitmK r 4 thrt permtl
Water Well
Mechanical Equipment
Fireplace/WoM Sto%e
Moving/Lifting Buildings
Land Alteration (Excavation.
(irading. Filling. etc.)
lk-,ign Review
Fire --- - ----- -
Sprinkler Svstem (Fire)
Other - -- -----
after-the-fart Im ,tigation
TOTAL
State Surcharge:
-16tal Amount Ixticd to City
❑ REMODEL
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S --_.
Fee S
Fee S
Fee S
Fee $
Fee S
'M% permit is not Vallis until the projm fee is paid:lld it i%approved
by an authorized City Oficial.
Sill&lurc of Applicant
SiFnat of CitV Official
C'etde whits Fite Cop% Ca:un Inv. fti K s Coln INA- t=irawr CWty Gold- Applicants Reodpt