HomeMy WebLinkAbout1987-03-17 Permit, Land Alteration #8936GENERAL PERNIIT
CITY OF ORONO
PO. BOX 66
CRYSTAL_ BAY. MINNESOTA 55323
(612) 473-7357
Owner _-- —
�hrContractor --- ^�--_-_--
Citv L.iccnse No. --------_-- — _ -- _--
REMA
PERMIT TYPE AND FEE:
Inside Plumbing (ftfixtures _
Water Meter (Size
Meter it —_ —
Remote tt ——
Municipal Water Connection
❑ Copper ❑ --
Municipal Sewer Connection
❑ PVC ❑ Cast ❑
MWCC SAC Charge
On Site Spetic System
ACKNOWLEDGEMENT
nwlc
❑ NEW
Fee S
Fee S
FLc S
Fee $
Fee S
Fee S
The urxkrstgncd tx'reh% acknowkdgcs receipt of this limited prrmn.
rrklLLhne 'iLve tiarkt' of all sprtwl information. term%. LOW1I10m Ix
reywrrnxnt% wnllen atxr%e. 111P untterslgrled under.urld� and agrees
inkier R•naht of L'o% th.n this permit isstn••!y% limited in so:opc• to the work.
.KU%n) ra Improcenlent slxrlfed: the .nis permit does not grant an%
.nnhont% todo w irk or attnluts n%tuinng sepurate permit appro%ah. and
Ihit this rwrmil does not grant authonp to %iodateam pm%rion odam Cm
ordlNrxx of SLllt' law, rifle lit reg111at1orl All work shall Ise dlnx• in strkt
cnmplcoke wuh .III (lt\ ordln1rkts. hudding itxis a1r1 or health
dcl,anment reg ula uom. and %hll tx• suhpect to imr cuun. appro%al or
relcYuon h% the Co tt'hene%cr so ordered, the underslpned agrcvs to
count an% %%ork found Io tv m %Iodation tit the condition, of this trrmn
Signature Applicant
❑ ADF
CITY PERMIT N? 8936
Date _ - - -7 -- V 7
Addre�� -- , � C: /
:lddres,s
Citt
ITION ❑ REPAIR
Water Well
Mechanical Equipment
Fireplace/Wood Stove
Moving/lifting Buildings
land Alteration (Excavation,
Grading. Filling. etc.)
Design Review
Fire —
Sprinkler System (Fire)
Other.
Aftvr-t'6c .art investigation
❑ REMODEL
Fee S _
FeeS—
Fee S _
Fee S —
Fee S
Fee S
Fee S
Fee S
Fee $
Fee S _
TOTAL �..
Stale Surcharge: Fee $
Total Amount Paid to Citv Fee $ S 2 1 ,7
This permit is not valid until the proper fie is paid and it is approved
by an authorised City Official.
it City Official
a 0/.
Ctxtr White File Cop, Canary Incptttor'. Copt fink Futanrr ('ups Gold- Applicant•% Rtceipt