HomeMy WebLinkAbout1982-10-27 Permit, Septic System #6860No
GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner 1 SIlli s,d
Contractor J OAJ Pe- 0 /o G
City License No,
REMARKS AND SPECIAL CONDITIONS
- ../Delo SE
CITY PERMIT NO. 68601
Date 0-7-
Address
T
Address 6)00Wrk�y'S,/hr
Address 9114 S -S-3
State License No.
PERMIT TYPE AND FEE: ❑ NEW
Inside Plumbing( # fixture )
Water Meter (Size )
Meter #
Remote #
EW
Fee S
Fee S
Municipal Water Connection Fee S
❑Copper a
Municipal Sewer Connection Fee $
❑ PVC [:]Cast n
MWCC SAC Charge
ACKNOWLEDGEMENT
Fee $
The undersigned hereby acknowledges receipt of this Umited
permit, including acceptance of as special Information.
terms, conditions or requirements written above. The
undo gored understands and agrees under penalty of law
that thle permit is strictly limited in scope to the work.
activity or improvement specified. that this permit does
not grant any authouty to do work or activities requiring
separate permit approval.: and that thia permit does not
grant authority to violate any provision of any City
ordinanceor State law, rule or regulation All work @hall be
done in sZt compliance with all City orm... 'a, building
codes and/or health department regulations, and hall be
subject to Inspection. approval or rejection by W City.
Whenever to ordered. the undersigned agrees to c.uysct
any work found to be in violation of the condition, of
this permit.
Signature of Applicant
Code: While -File Copy canw--hupector's Cov,
❑ REPAIR
On Site Septic System Fee S
Water Well Fee $
Mechanical Equipment Fee $
Moving/Lifting Buildings Fee $
Land Alteration (Excavation, Fee S
Grading, Filling, etc.)
Other: Fee S
After -the -fact Investigation Fee S
TOTAL
State Surcharge: Fee S A e0
Total Amount Paid to City Fee $/1017.Sl
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
re of Ci
nak -Finance Copy Gold -Applicant's Receipt