HomeMy WebLinkAbout1985-08-13 Permit, Septic System #8038GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
OwnerA,.'
Contractor Duan X141 -e-1
City License No. 1ma—d
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 8038
j
DateJ, 5
Address ;
Address _ -7,/00
1
State License No.
PERMIT TYPE AND FEE: )d NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing Ofixtures_) Fee S (Water Well Fee S
Water Meter (Size—) Fee S
Meter#
Remote
Municipal Water Connection Fee S
❑Copper []
Municipal Sewer Connection Fee S
❑ PVC 0 cast rl
MWCC SAC Charge
On Site Septic System
ACKNOWLEDGEMENT
--- IMechanical Equipment
Fee
Fee S 'Ori
The undersigned bereby acknowiedess receipt of this limited
Permit, Y eMftg accoVionce of all svecial information.
teras, conAliaas or requirements written above. The
uaderdowd vrtierstaads and agrees under penalty of law
tat tib pstmit is strictly limited in scope to tie work.
activity or improvement specified: that lib permit does
not pant my autiorlb to do wait or activities requiring
nParale vomit gvrovala: and let tib permit does not
grant autiority so violate ear Provision of nay qty
ordiaaaee or Stale law, rub or regulation. AN work siag be
done in strict compliance wild dl City ordinances. budding
codes and/or besiM deParlment regulations, and iso be
aibleet to btsveedoa, smovel a reiecakm by the City.
Miaaever so ordered. tie undersived agrees to cornet
my wash found b be is violation o! the conditions of
HW permit.
Signlatu of Applicant
Code: White -- File Copy
Canary Antpector's Copy
ing /Lifting Buildings
nd Alteration (Excavation,
Grading, Filling, etc )
Fee S
Fee S i
Fee S
Fire Fee S__
Sprinkler System (Fire) Fee S
er:
,r-tbe-fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S
Fee S
Fee S 60
Fee $ % cj• 61
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Si ature of City Official AO
Pink -Finance Copy
Cold -Applicant's Receipt