HomeMy WebLinkAbout1981-12-23 Permit, Natural Gas HVAC Conversion #6604General permit
CITY OF ORONO
P.O.BOX 66
CRYSTAL. BAY, MINNESOTA 55323
(612)473-'’357
CITY PERMIT NO." 6604
Date /^ ^ ^/
Owner ' Address ^ ^0 D ____________
Contractor fi \Al LLJ^^ ^L ajl^ Address ^ S
City License No. State License No. . _______________________
REMARKS AND SPECIAL CONDITIONS
/ev,ooo tMU
PERMIT TYPE AND FEE:□ NEW □ ADOmON □ repair
Inside Plumbing ( # fixturrs,_)Fee s On Site Septic System Fee
Water Meter (Size_)Fee S Water Well Fee
Meter §
Remote #
Mechanical Equipment Fee
Municipal Water Connection Fee $__________Moving/Lifting Buildings Fee
D Copper D____Land Alteration (Excavation,Fee
Grading, Filling, etc.)
Municipal Sewer Connection Fee S
n pvc n Cast n Other:Fee
MWCC SAC Charge Fee $Afte^the-fact Investigation Fee
ACKNOWLEDGEMENT
Th« unimMpMd hmbir aduiowliddM nc«ipt of OUi limited
ptmitt, iMliidlBg oaoapteBeo of «U modal tetonnattoii.
teima, eoBdMoM or roauiiomonto wdUea abovo. Tha
dgaad uadonteado oad amooa uadar poaalte of law
teat tela paoait ia atriater tealted la aaopo to tea woafc,
activity or taaptovanant madflad: that thla poonlt dooa
aot paat aay auteoilty to do wetk or aetivittoa aomtelaa
aopaiate panalt aporovala: aad teat tela paaalt doaa aot
gtaat auteoilty to violate aay proddoa of aay City
nriiaaana or State law, lula or lafulatloa. A1 work teall ba
dooa la atdet eompHaaaa with all aty ordteaoaaa, bulldlog
aodao aad/or haalte dapmtmaat laeulatlooa. aad tedl bo
auWaat to teapaatloo. adprovd or lalootloa by tea aty.
Wbaaavar oo ordaiad, tha Modaidgiad ago it to coma t
aay work fouod to ba la vlolatloo of tha eooditlooa of
thlayocmlt.
Signature of Applicant
TOTAL
State Surcharge:
Total Amount Paid to City
Fee «
Fee « 3.0. SO
This peimit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
Code: White-File Copy Guiaiy-lnipector’t Copy nak-Finance Copy Gold-Applicaat't Receipt