HomeMy WebLinkAbout1984-11-01 Permit, Sewer Connect #7694GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
CITY PERMIT NO. 7694
Date — /- 07
Owner J OAJ / V E"OVU Address Y,030 b 4-NL 4[0kt�
Contractor W t 1>m e9e ins 1N L Address L�/NX, P.a-j,,CXc
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: W1 NEW ❑ ADDITION
Inside Plumbing (Mixtures_) Fee S
Water Meter (Size—) Fee S _
Meter #
Remote Ai
Municipal Water Connection Fee S
[]Copper n
c+ U
Municipal Sewer Connection Fee S _3 --
;ZPVC ❑ Cast n
MWCC SAC Charge Fee S
On Site Septic System
ACKNOWLEDGEMENT
State License No.
❑ REPAIR
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation
Grading, Filling, etc.)
Fee
S
Fee
S
Fee
S
Fee
S
Fire Fee S
Sprinkler System (Fire) Fee S�
Other: Fee S
Fee S /After -the -fact Investigation Fee S
The undersigned hereby acknowledips receipt of this limited
permit, including acceptance of all special information,
terms, conditions or reQutrements written above. The
undersigned understands and agrrecs under penalty of law
that this permit is strictly limited in scope to the work,
activity or Improvement specified; that thla permit does
not grant any authority to do work or activities repuirins
separate permit approvals; and that this permit does not
grant authority to violate any provision of any City
ordinance or State law, rule it regulation. All work shall be
done in strict compttance with all City ordinances, building
codes and/or health department regulations, and &hall be
subject to inspection, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this pennit.
Signatur of Applicant
TOTAL
State Surcharge: Fee $ Sa
Total Amount Paid to City Fee S
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
Code: White-l:ilc Copy Canary Inspector's Copy Pink -Finance Copy Gold-AppUcant's Receipt