HomeMy WebLinkAbout1984-11-14 Permit, Septic System #7710GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
CITY PERMIT NO. 7710
Date
Owner �1.7f' !�— Address 4- n a ! w 0 41 4:e444
Contractor ^ 1,,,4 r nr Z� Address ��Q Ol✓ '
If f
City License No. r-;? d (9S State License No.
REMARKS AND SPECIAL CONDITIONS
Ql 1 Dn 039 21- k S. (- ,are- e o s4 // C? o � � � Cjk/'rx icy
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PERMIT TYPE AND FEE
Inside Plumbing Wixtures_)
Water Meter (Size _)
Meter
Remote
❑ NEW ❑ "EDITION
Fee $ _
Fee S__-_
Municipal Water Connection Fee S -----
❑ Copper n
Municipal Sewer Connection Fee
❑ PVC ❑ cast (-1
MWCC SAC Charge Fee S
GI Site Septic System Fee S 00
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special information,
lem,s, coudition< or requirements whiten above. The
undersigned ut nds and agrees under penalty of law
th.' :his perr. trictly limited in scope to the work,
actA.cty or imp nent specified: that this perms does
not grs,. •,nv authonty to do work or activities requiring
separate permit approvals: and that this permit dues not
grant authority to violate any provision of any City
ordinance or State law• rule or regulation. ALI work shall be
done in atrlct cmmpliance with all City ordinances• budding
codes andlor health department regulations, and shall 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 permit.
Signature ' Applica
Cl REPAIR
ater Well
anical Equipment
/Lifting Buildings
Land Alteration (F ;cavation,
Grading. Filling, etc.)
Fee
$
Fee
$
Fee
$
Fee
S
in Fee $
.inkler System (Fire)
Fee S
ther: Fee $
fter-the-fact Investigation Fee $
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $ - C� O
Fee S 7'3' ';0'
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of Cit; `Jf Ic: ll
,E&JLst, (7,K)
Code %'hire -I Ile Cnpy Canary Inspector's Copy Pink -I inance Copy Gold -Applicant's Receipt