HomeMy WebLinkAbout1985-11-12 Permit, New Septic System #8179GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL 3AY, MINNESOTA 55323
(512)473-7357
CITY PERMIT NO. 8179,
Date i�l
0,_,nor iOki / i�(_ %lll'L/liL Address <��`�1 l�lL%�/6<-1 l !/7 17d
Contractor �' '1 �u � /in:21 :7) Address C O ' -1 4,1
City License No. 1�) rl State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
ide Plumbing Ofixtures_)
,NEW ❑ ADDITION
Fee S I
er Meter (Size_) Fee S
Meter#
Remote
cipal Water Conne,.tion Fee S —.
❑Copper ❑
ipal Sewer Connection
PVC ❑ Cast
SAC Charge
Septic S� stem
)WLEDGEMENT
Fee S _ -
❑
Fee S - -
Fee S ' f.
to undersigned hereby acknowledges receipt of chis limited
rmit, including acceptance of all special information,
ms, conditions or requirements written above. The
ie:4ned understands and agrees under penalty of law
t this permit is strictly limited in scope to the work,
vity or improvement specified; that this permit does
grant any authority to do work or activities requiring
rate permit approvals; and that this permit does not
t authority to violate any provi,!on of any City
ranee or State law, rule or regulation. All work shall be
In strict compliance with all City ordinances, building
and/or health department regulations, and shall be
!t to Inspection, approval or rejection by the ray.
• er so ordered, the undersigned agrees to correct
•ork found to be in violation of the conditions of
rmit.
')"'/,
plicant
Z u l
❑ REPAIR
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee
S
Fee
S
Fee
S
Fee
S
Fire Fee S
rinkler System (Fire)
her:
ter -the -fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S
Fee S
Fee S
'13
Fee S *' r_
Fee S 7�S
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
SignatW of City Official
(lode White I ile Copy Canary Inspector's Copy Pink A inance Copy
a
Gold -Appiicant's Receipt