HomeMy WebLinkAbout1986-10-22 Permit, Septic SystemGENERAL PERMIT CITY PERMIT N? 8745
CITY OF ORONO
P.O. BOX 66 [gate
CRYSIAI. BAY, MINNESOTA 55323
(612) 473-7357 C/�rt' // �}- h c �/ Alk
Owner A( L
— --- Address
ContractorQ/_' Address
City L.ic�ense No. t0 UVJ City
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures )
Water Meter (Sim �)
Meter #
Remote #
Municipal Water Conner
❑ Copper ❑ _
Municipal Sewer Connection
❑ PVC ❑ Cast U ._
MWCC' SAC Charge
On Site Spetic Ssxtem
ACKNOWLEDGFMENT
T I t I I r t -1101 0
NEW ❑ ADC
Fee S
Fix $
Fee S
Fee S
Fee S
Fee S
IN- under,Wnd hcrch% ackntwltdgm rnetpt ttf this limited permit.
tniudtrtg aatptame rd all sptyy; mkwrnation. ternm ctwtdnatns tw
eyutremenn wntlen Ant IV unempned understands and altimN
urtder renal% d law that this permitn strw-d% hmird m gnttc ht the work.
Astons t% rmprtww"L•m %Iwifted. that this permit toes nit grant am
authonts Aida wtwk or acusttea rc4111n119 •c•Itaratr ptrmiutpprosak. and
that thn prrmtt dies n t gram auttk nt% u, tittlar ans prosiwtwt dam ('ns
Zinarwr or State law ruleto rep uldtion ll wore hit h• don to -Arkt
.ompltane with all ('us ordtnanct,. hudding .tsk, and'cw health
delwnmcm regulatiom and %hall Ie %uhtsri to insproi4m, approsal or
reKrnon ht the ( lt% WhCriew vt twdend the undetagned agree, w
a,r rrt r am work found to be in t u datttwt td Iht• . onditu tm d thts per mit
Suture of Ap licant
HTION O REPAIR
Water Well
Mechanica! Equipment
Fireplace/Wood Stove
Moping/Lifting Buildings
Land Alteration (Ex(avation.
Grading, Filling, etc.)
Design Review
Fire
Sprinkler System (Fire)
Other.
After -the -fact Inwstigation
❑ 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
SD
lit4tl Amount Paid to City Fee !•
This pernut is net valid until the proper :cc is paid and it is approved
by an auth067LIJ City Official.
Signature of City Offiial`�
('ttdc U htte file tops Canary-- Inspector's Copy Pink– lFinanie Copy (Sold—Applicant's Receipt