HomeMy WebLinkAbout1985-07-26 Permit, Water Well #8008GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner W f I CA 0 �Iohmcw) �TU2;)'e%,U0r_A'
Contractor—To r 5eyson We I l La. J L3 f\
City License No,
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REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: X NEW ❑ ADDITION
Inside Plumbing (#fixtures_) Fee S
Water Meter (Size_) Fee S
Meter#
Remote #
Municipal Water Connection Fee S
❑Copper ❑
Municipal Sewer Conuection Fee S
❑ PVC ❑ ( ast r—
MWCC SAC Charge Fee $
On Site Septic System Fee S
ACKNOWLEDGEMENT
The undersigned hereby acknowledMs receipt of this limited
Permit. including acceptance of all 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 activities 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 all City ordinances, building
codes and/or health department regulations, and shall be
sublact to Inspection, approval or resection 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
OIC14 -. ln-1
CITY PERMIT NO. 8008
Date 7 - c� Co~ &5
o?5Co5 Coun4rtj51de_ ,ter.
Address 1
Address (P955 !��vood $+�
. /� A'!eld
7►'l V 55 3 73
State License No. '9,765(o
❑ REPAIR
Water Well
Mechanical Equipment
Moving /Lifting Buildings
I -and Alteration (Excavation,
Grading, Filling, etc.)
Fire
Fee $ ,� • Qd
Fee S
Fee S
Fee $
Fee S
rinklerSSyMail-
stem (Fire) Fee S
/
hes. (+ IaI l - in Fee $ r' 50
fter-the-fact Investigation Fee S
TOTAL
State Surcharge: Fee $ _ -6�)
Total Amount Paid to City Fee $ - °_U()
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
TC17 c�C/r1.1W
Code: White—File Copy Canary —Inspector'r Copy Pink—Finance Copy Gold—Applicant's Receipt