HomeMy WebLinkAbout1985-07-24 Permit, Water Well #8004GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner
Contras
City Li
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 8004
Date C L/! �? �—
Address 0..
Address
State License No.
PERMIT TYPE AND FEE: 'NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) Fee S IWater Well Fee S &O W
Water Meter (Size _) Fee S
MeterN
Remote #
Municipal Water Connection Fee S _
[]Copper n
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast n
MWCC SAC Charge Fee S _
On Site Septic System
ACKNOWLEDGEMENT
Mechanical Equipment
ng /Lifting Buildings
nd Alteration (Excavation,
Grading, Filling, etc.)
ire
rinkler Syste,a (Fire)
ther:
Fee S lAfter-the-fact Investigation
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
'bat this permit is strictly Walled in scope to the work,
activin
ty or improvement specified: that this permit do
not pant any authority to do work or activities requiring
separate permit approvals; and that this permit does not
pnt aauthority to violate soy provision of any City
ordinsoce or State law, rule or regulation. All work &bail be
does in strkt compliance with all City ordinances, building
cod" and/or health department regulations, and shall be
w'blott to tnspectloo, approval or rejection by the City.
Wbenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
th" permit.
'ure of Applicant
TOTAL
Fee S
Fee S
Fee S_
Fee
S
Fee
S
Fee
S
Fee
S
State Surcharge: Fee S -1 5V
Total Amount Paid to City Fee S ' !o
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature ty Official
', Code: White - File Copy Cain vy-Inspector's Copy
Pink -Finance Copy Gold -Applicant's Receipt