HomeMy WebLinkAbout1983-02-20 Permit, Water Meter #6950GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
CITY PERMIT NO. 695a
Date 2-- 2 Z - 13
Owner Lbe,44 1
- - _- Address
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Contractor
Address
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City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION
Inside Plumbing ( # fixtures ) Fee $
Water Meter (Size1L) Fee $
Meter # "++�vter�� •�C�S�/�
Remote # 139 r3
00
Municipal Water Connection fee $_
❑ Copper n
Municipal Sewer Connection Fee $
❑ PVC ❑ Cast n
MWCC SAC Charge
ACKNOWLEDGEMENT
Fee $
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special information.
terms, conditions or requirements written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited In scope to the wark,
activity or improvement specified; that this permit does
not grant any authority to do work or activities requiring
separate permit approvals; and that this permit does not
grant authority to violate any provisinn of any City
ordinance or State law, rule or regulation. dill work shall 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 undersi;ned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signa of pplic• nt
State License No.
❑ REPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Other:
After -the -fact Investigation
TOTAL
Fee
S
Fee
S
Fee
S
Fee
S
Fee
S
Fee
$
Fee
c
7S7.00
State Surcharge: Fee S
Total Amount Paid to City Fee Ste__
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Sign
Code: White -File Copy Canary - Inspector's Copy Pink- I finance Copy Gold -Applicant's Receipt