HomeMy WebLinkAbout1986-06-02 Permit, Septic System #8497GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
II)) (612) 4,,73f-7357
P_e_Q � Owner V�� icLJ
Contractor
City License No. 1
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures_)
Water Meter (Size—)
Meter#
Remote #
CITY PERMIT NO. 8497
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Address f h Q
Address h� � � . � '(� .41n (A
State License No.
0
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NEW ❑ ADDITION ❑ REPAIR
Fee S lWater Well
Fee 5 IMechanical Equipment
Municipal Water Connection Fee S _
[]Copper ❑
Municipal Sewer Connection Fee S _
❑ PVC ❑ Cast r_
MWCC SAC Charge Fee $ _
On Site Septic System
ACKNOWLEDGEMENT
Fee S
The undersigned hereby acknowledges recelpt of this limited
Permit. including acceptance of all special Information,
terms, conditions or requirement& written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited In scope to the work,
activity or improvement specified: that this permit does
not grant any authority to do work or activities requiring
eePar*
it permit approvals. and that this permit does not
grant authority to violate any provision of any City
ordinance or State law, rule or regulation. All work sbW be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
subject to L.rpection, 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.
C' ., a o� pl ca
�+ Code.White-FilcCopy Canary -Inspector's Copy
ng /Lifting Buildings
Cuje_}MN D2d / N S
Fee $
Fee $
Fee $
Land Alteration (Excavation,
Fee
$
Grading, Filling, etc.)
Fire
Fee
$
Sprinkler System Fire)
Fee
$
Dther:
_ Fee
e
$ ,��
After -the -fact Investigation
Fee
$
TOTAL
State Surcharge: Fee $
Total Amount Paid to City Fee $/w
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature,pf City Official
Pink -Finance Copy
--Applicant's Receipt