HomeMy WebLinkAbout1983-01-11 Permit, Water Hookup #6925GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
CITY PERMIT NO. __69261
Date I - I W �
Owner Vr ANDF_2Sn(\J Address 18,557 C0AX_0eDr 3
Contractor vii AsimAXA PLF%� Address WASIZArA �
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
SAC 'Pd �ve_m, t �to�
PERMIT TYPE. AND FEE: XNEW ❑ ADDITION ❑ REPAIR
Inside Plumbing ( # fixtures ) Fee $ I On Site Septic System t-ce S_
Water Meter (Size )
Meter #
Remote #
Fee $
��
O U
Municipal Water Connection Fee $_;X6
Copper a
� eo
Municipal Sewer Connection Fee $
❑ PVC ❑ Cast
MWCC SAC Charge Fee $ f ?A
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of as special information,
terms, conditions or requirements written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited in scope to the work,
activity or improvement specified; that this Permit does
not grant any authority to do work or eFtivides requiring
separate permit approvals; and that this Permit does not
grant authority to violate any provision of any City
ordinance or State law, rule or regulation. All work shall be
done in strict compliance with as City ordinances, building
codes and/or health department regulations, and shall be
abject to inspection, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of Applicant
Water Well Fec S _
Mechanical Equipment Fee S—
Moving/Lifting Buildings Fee S
Land Alteration (Excavation, Fee S
Grading, Filling, etc.)
Other: Fee S
After -the -fact Investigation Fee S
TOTAL
State Surcharge: Fee S /00
�/, 00
Total Amount Paid to City Fee S ly/.
This permit is not valid until the proper fee is pall and
it is approved by an authorized City Official.
Si m• t e f City Offic'
Code: White -Pile Copy Canary- lospectur's Copy Pink I mance Cop> Gold Applicant's Receipt