HomeMy WebLinkAbout1985-01-23 Permit, Water Meter #7791GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner
Contractor x ru //�.�_ hinG�
City License No. I &
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 7791
Date _-1 —,23 — O
Address -3 1/� Re
If
Address _ J�r��
State License No.
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing 0fixtures_) Fee S Water Well
Water Meter (Size Fee S 1,3Q• too Mechanical Equipment
MeterjlE / io %
Remote Moving /Lifting Buildings
Municipal Water Connection Fee S
❑Copper r
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast n
MWCC SAC Charge Fee S
� On Site Septic System
ACKNOWLEDGEMENT
Fee S
The undersigned hereby acknowledges receipt of this limited
permit, Including seeeptance of all special information,
terms, conditions or requirements written above. The
undersigned understands and agrees under penalty of law
that title permit is strictly limited In scope to the wank,
activity or improvement specified; that title permit does
not pent my authority to do work or activities requiring
separate permit approvals; and that this permit does not
grant authority to Notate ear provision of ray City
ordinance or State law, rule or regulation. AD work @bell be
done in strict compliance with all City ordinances. building
codes and/or health department regulations. and shall be
subject to inspection, approval or rejection by the City.
Whenever so ordered. the undersigned apses to correct
any work found to be in violation of the conditions of
this permit.
Signature of Applicant
100,
Land Alteration (Excavation,
Grading, Filling, etc.)
inkler System (Fire)
ier:
er-the-fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee
S
Fee
$
Fee
S {
Fee
S
Fee S !i
Fee S _
Fee S
Fee S_ I'.
Fee S
Fee S
This permit is not valid until the proper fee is paid and
i* is approved by an authorized City Official.
Signature of City Official
Code: White --File Copy
Canary —Inspector's Copy
Pink —Finance Copy Gold -Applicant's Receipt