HomeMy WebLinkAbout1987-04-21 Permit, Land Alteration #8972GENERAL PERMIT
CITY OF ORONO
CITY PERMIT N? 8972
P.O. BOX 66
CRYSTAL BAY, MINNESOTA 55323
�� (612) 473-7357
Owner C— •cirgs E S
Contractor e w
City License No.
REMARKS AND SPECIAL CONDITIONS
Date 4-ZI — 97
Address _35,3 3 Cr y ss.-M L -PL
Addns 353� T�l,_ �L
City
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PERMIT TYPE AND FEE. -
Inside Plumbing (#!fixtures )
Water Meter (Size )
Meter #
Remote a _
Municipal Water Connection
❑ Copper O
Municipal Sewer Connection
O PVC ❑ Cast ❑
MWCC SAC Charge
On Site Spetic Svstem
ACKNOWLEDGEMENT
❑ NEW ❑ ADDITION ❑ REPAIR
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
The undersigned hemby acknowkditm rttiript of this limited permit.
including atu-pwamv of all aprc'ial information. terms. condinnm or
requirements written ahow. The undersigmed urdenarwts and agrees
under penalty of law that this prrmn tswiuly limited in wopr to the %ork.
actisity or impwownwrit specified: that this permit dons new grant any
authority todo work o r aciisitics requiring seperatc permit appnnah: anJ
that this prrmu dons not gmi authority to sidar any p rosision of any City
owdiromr or Stale law, rule or regulation. All work shall to dome in strict
oarmpliame with ap City omlirongec, building ctides and/or health
department regulation+, and shall be at4xt to impection, approsul or
rcjmtion by the City. When ewr +o ordered, the undersigned agrees nr
comIct an s work f6uml to he in siolation of the conditions of this permit.
Signature of Applicant
Water Well
Mechanical Equipment
Fireplace/Wood Stove
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Design Review
Fire
Sprinkler System (Fire)
Other.
After -the -fact Investigation
TOTAL
❑ REMODEL
Fee S
Fee S
Fee S
Fee S
Fee SO•C%V
Fee S
Fee S
Fee S
Fee S
Fee S
State Surcharge: Fee $ So
'mac
Total Amount Paid to City Fee S SD
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
City
Code: White File Copy Canary Inspcoox s Copy Pin{ Finantr Copy Cmld- - Applicant's %xviptt