HomeMy WebLinkAbout1983-06-08 Permit, New Water Well #7022GENERAL PERMIT CITY PERMIT NO... 70221
CITY OF ORONO Dat
.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(61 22) 473-7357
Owner Kuri Address cUi0+`SAA e -
Contractor �lQ.��� eL(- Address F�DEti✓ QfA(L►(Z- KA --V%
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE. AND FEE: XFW
Inside Plumbing ( # fixtures )
Water Meter (Size )
Meter #
Remote +�
❑ ADDITION
Fee S
Fee S
Municipal Water Connection Fee S
❑Copper
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast Q
MWCC SAC Charge
ACKNOWLEDGEMENT
Fee S-
The undersigned hereby acknowledges receipt of this limited
parent, Including acceptance of all spec/al information,
tensa, conditions or requirements written above. The
undersigned understands and agnea 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 activities requiring
separate permit approvals; and that this permit does not
grant authority to violate any provision of any City
ordinance or State taw, rule or regulation. All work shall be
dons In stilet compliance with W City ordinances• building
codes and/or health departaient regulations, and shall be
subject to Inspection, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be to violation of the con tions of
this permit,
re o plican t
Code. White file Copy Canary Inspector's Copy
RI. ❑ REPAIR
On Site Septic System Fee S
Water Well Fre S
2000
Mechanical Equipment Fee S
Moving/Lifting Buildings Fre S
Land Alteration (Excavation. Fre S
Grading, Filling, etc.)
Other: _ Fee S
After -the -fact Investigation Fee S
p0.
TOTAL
State Surcharge. Fee S.,Oro
�
Total Amount Paid to City Fee S.07Qis
This permit is not valid until the Prot . fee is paid and
it is approved by an authorized City ("
Signature of City Oftici
/ ..
Pink I finance Copy Gold Applicant's Receipt