HomeMy WebLinkAbout1985-08-13 Permit, Septic System #8037GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 5533
(61 2) 473-7357
CITY PERMIT NO. 8037
Date
Owner _,iCQ/.Address
Contractor ,n—�i I t/C� jC(7( ®lI7state
ddress
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City License No. /�/License No. )�
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE: AND FEE: *NFW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) Fcr S _" lW'ater Well Fee S
Water Meter (Size_)
Meter#
Remote ti
Fre S — ----Mechanical Equipment
Municipal Water Connection Fee S _
❑Copper F]
Municipal Sewer Connection Fee S -
❑ Pvc ❑ (-a.t n
MWCC SAC Charge
On Site Septic System
ACKNOWLEDGEMENT
Fee S
owing 'Lifting Building,
Fee S
Fee S
and Alteration (Excavation. Fee S
Grading. Filling. etc )
IFire Fee S
nkler System (Fire)
her:
Fee S Citi
After -the -fart Investigation
The undersigned hereby acknowledges receipt of this limited
permit. Including acceptance of W special information.
terms. conditions or requirements wdtten above. The
undersigned understands and ag-ees under penalty of law
that this permit is stricUV limited in scope to the work,
activity or Improvement specified: that this permit does
not grant any auU.orlty to do work or activities requiring
separate permit approvals: and that this permit does not
grant authority to violate env 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 andjor health department regulations. and shall be
subject to inspection, Lpproval or miectlon 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 f Applicant
L- Code: MbiM—FIM Copy Canary Inspector's Copy
TOTAL
State Surcharge:
k'o.al Amount Paid to City
Fee S
Fee S
Fee S 1
Fee S ' e) '
Fee 2-6 5
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Sign lure of City Ofticia
.,
Pink I inance Cop> Gold Applicant's Receipt