HomeMy WebLinkAbout1986-12-05 Permit, New Water Well #8823GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 44}733--7357
Owner L! J''L
Contractor Co
Cite License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE:
Inside Plumbing Ofixwrt:s
Water Meter (Si/e.---)
Metef a ---
Remote V —
Municipal Water Connl•ction
❑ Copper ❑ - —
Municipal Slower Connection
❑ PVC ❑ Cast ❑
MN CC SAC Charge
On Site Splotic System
ACKNOW LEDGEM E114T
�f N IAV
Fee S
Fee S
CITY PERMIT N? 8823
Date Tr.�
Address D !. SCLC t %OUJ /C -OI
Address ---
City
❑ ADDITION ❑ REPAIR
Fre S .._.------_.-.--
I-ce S __---.-
Fee S - - ---
Fee S --.—
Ili• nmk-f%Wntt'd Meeh% a— bJpc+ m'opt u( tht. Itmrkd rmfi rt.
ukitdtng aivriarkt• of all %rw wl mfircrmmnt 4mt%. oWiltnn. ,w
:4tutemems wnUen tN,%v The untletwterkd urklerntand, and eFrce.
under "Itvd Iaw that tht, lkcnnn!, drwth hmnrJ in vnpr u,the wnrk.
;nmm or tmpnownx•nt .jv.tfttl. that the, tknad J,k•, MN gram any
autM,nIN Kinn work ,I I,LvU,� v,junink v-puntr rwinntapl,n,,;d..tnd
thaIth,,r rmtldootit-Ivran,amh„nt,I,,,,nlak-ampnuno,n,dam(uv
„rdmark-,' nr Swc U1 rid, nr repulauon All work Kill N ,h,n• to irk
,nrttpltarxc with all (lt, „rhnan.t� hutkhry .nJt, itkl ur hcdlh
departmt•nt «-Fula* . n. aril .hall h, .til-wo to m.lkl Utm. appr,,,al ,rt
n•pi tkxt ht the ( it% %%licne,t!-nrdertd. tht• utx..-wx',l arTo, to
,nen•,t.rn% t,..rk Inmkl toM in ,r, lannn the.,nxlal. m i It,,, perrnrt
Signature of Applk3nt
Water Well
Mechanical Equipment
Fireplace/ WN)d Stone
Moping/Lifting Buildings
land Alteraticn (Ext;avation.
Grading. Filling, etc.)
Design Revxw
Fire --
C REMODEL
Fee S—�
Fee S
Fee S —
Fee S
Sprinkler Ssstem (Fire).
Other: -_ 4 / C o- —
Mter-the-fact Insestigation
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
TOTAL
State Surcharge: Fee S ? fJ`�
Total Amount Paid to City Fee S�
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
nattuq of City Official
Oak Whar I•fle Ctyn Canan Imptoor', Cop% Ihnk Finanw Ccgn Gait--AppkI M's Reaeip