HomeMy WebLinkAbout1985-09-19 Permit, SAC #8009GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Owner
Contractor
city Ucenie No__________
REMARKS AND SPEQAL CONDITIONS
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CITY PERMIT NO.8099
Date.
Addren Co
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State License No__________________________
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PERMIT TYPE AND FEE: □ NEW □ ADDITION □ REPAIR
Inside Plumbing (Ifixtures
Water Meter (Size )
-)Fee
Fee
$
S_
Water Well
Mechanical Equipment
Fee
Meter#
ree
Remote #Moving /Lifting Buildings Fee
Municipal Water Connection
rirnnner fl
Fee s Land Alteration (Excavation,Fee
Grading, Filling, etc.)
Municipal Sewer Connection
□ pVC Dcast
Fee f Fire Fee
CL
a----------------
Sprinkler System (Fire)Fee
MWee SAC Chaise Fee $Other:Fee
On Site Septic System Fee ^7^.00After-the-fact Investigation Fee
ACKNOWLEDGEMENT
Tb« uadMlVMd h«Nby •ekaowMaM neaipt of this Uailted
POOBit, laeliidini ■booHobco of all «oeUl tefomattoa,
tonaa. coadHIoBa or naulmaoata wdnaa abovo. Tha
i
uad«tal«BOd uadatataada aad agaaa uadar panalty of law
that thia panalt la atriedsr ttaillad la aeopa to tha work,
aettvitir or haprovaaiaat ^aelWadt that dda panalt doaa
aoi gnuit any audiotllr to do weak or aethrltfait raqulitaf
aaparata pataalt approvala: aad that thla panalt doaa aot
■rant authoilty to vlolata aar provlaloa of aap City
ocdlaaaeo or SUta law, nila or ragulatloo. All wotk ahaU ba
doaM la aMet eompUaaea with aD atr ordlaaaoaa. buildlaf
eodaa mtd/or haalth dapartaaat rafulattoaa. aad aha! ba
auhlaot to kupaetloa, approval or tajactloa by tha aty.
Whaaavar ao oadaiad. tha aadaialffiad affoaa to eonoet
aay woah fooad to ba la vlolatloa of tha eoadltlooa of
thla parade
Signature of Applicant
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TOTAL
State Surcharge:
Total Amount Paid to Qty
Fee $.
Fe,
This permit is not valid until the proper fee is paid and
it is approved by an authorized Qty Official.
Signature of City Ojpeial
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Coda: White-FUa Copy nrnary-Inspector’(Copy Pink-Flnaiice Copy Cold-Applk»t*l Rpoelpt