HomeMy WebLinkAbout1987-05-08 Permit, Septic System #8999GENERAL PERMIT
CITY OF ORONO
VO. BOX 66
CRYSTAL BAY. MINNESOTA 55323
Nk
12) 473-7357
Owner �— IN - .
(
Contractor --- Jit L " _%1- - — - - ____
City l.ic.:r>sc No. — ---- `� �------ — --
REMARKS AND SPECIAL <CONDITIONS
PERMIT TYPE AND FEE:-
Inside
EE:Inside Plumbing (#fixtures _)
Water Meter (Sin �)
Meter At
Remote a _
Municipal Water Connection
O Copper O
Municipal Sewer Connection
❑ PVC O Cast O
MWCC SAC Charge
On Site Spetic System
ACKNOWLFIGFMENT
O NEW
Fee $
Fee $ _
Fee S
Fee S
CITY f'F.RMIT N° 8999
—..-_-- AddressCity
_
Date _-- '57— 8—
O ADDITION O REPAIR
Water Well
Mechanical Equipment
Fireplace/ Wr . we
Moving/ Liftint: dings
Land Alteration ( Excavation.
Grading. Filling. etc.)
Deign Review
Fee S
Fee S ,
Ilk- untdv Wnced h,veln arkn„wkifln- rcterrrt ,A th,, hmtted rrrmav
in,•ludrrg accrplanct- ,f all •rxrtal mhnmauon. 11.1111.. o,nndanut. „r
rterwtcnwnH wnik-n alt,ce nx• unok-mpn,el urkkntand, and apvc,
unck-F r,eretltc ,A raw that IN% rxrma r% urkrl% limited to v orx• at the work
armor ,x rmkpimemeni l%-tiFk-d. that the, rx•rmt drt, n,A print am
autMntc tuc, w,xk,x acLt aie' k-ywnng v purat• rrrmrt appro,al.. and
that thn rtrmadirt. MAFrant auth ntc u, cu,luk•;in% panr.un,A am ('rt%
radrmn&e,e State law ruk- w n'Yulauon All work hall N• d,nk• rnVrirt
a,mrAmnrc with all ('etc ondinarkt-. Nuking r,ak, .i tl or health
,krmnnwiti repu4unn• and .hall lx• .uhjcei it, nyxttnon, appy„cal or
repeUon h% the (lt% Nhenecrr .,,,ud-fed the untlrr.,knked ak,ty% it
,Diner arrc work burl to lie in cud,tu,n,A the curdruom,A fill, (morn
Signature of Applicant
Fire
Sprinkler System (Fire)
Other:
After -the -fact Inletigation
O REMODEL
Fee S
Fee $ _
Fee $_
Fee $ _
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
TOTAL 7T
State Surcharge. Fee S 5 C�
Total Amount Paid to City Fee S ,� S (J
This permit is not valid until the proper fee is paid and it is approved
by an authorircd City Official.
Signature IC'ity Official
(„dr N httc I tk• ('opt ( `anar.% Imrxeior', ('op% Pink I uutncr ('opt (weld Appliain i Raeir4