HomeMy WebLinkAbout1986-02-10 Permit, Septic System #8339GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
,�,,, I(612) 473-7357
Owner Z)"e IVy/LL 4y_1%-S ,111/1 Sj
Contractor Pl� Siws
City License No.
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 8339
Date 2 — /0 -- 86,
Address c 3 ��/�J Z.�+Nlt�
Address �C�>
State License No
4!�/S O� SpLt-r— -r.C(/►_S
900 s � 5;:1VM-L0L J Tw-y"CIA, �-
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures_)
Water !Meter (Size—)
Meter#
Remote
XNEW
Fee
Fee
Municipal Water Connection Fee
❑Copper Q
Municipal Sewer Connection Fee
❑ PVC ❑ Cast
MWCC SAC Charge
On Site Septic System
ACKNOWLEDGEMENT
❑ ADDITION ❑ REPAIR
S Water Well
S --- --- Mechanical Equipment
Moving /Lifting Buildings
5 ! _ _ Land Alteration (Excavation,
Grading, Filling, etc.)
Fire
Sprinkler System (Fire)
Fee
S
Fee
S
Fee
$
Fee
S
Fee S
Fee S
Fee S - '�- - Other: Fee S
Fee SAfter-the-fact Investigation Fee S
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
that this permit is strictly limited !n scope to the work.
activity or improvement specified: that this permit does
not grant any authority to do work or activities requiring
separate 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 shall be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and &hall be
abject 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 of Applicant
i
7
.I
TOTAL
State Surcharge: Fee S 5_0
$o
Total Amount Paid to City Fee $ /&0_
T!..s permit is not valid until the proper fee is paid and
it is approved by an authurized City Official.
Signature .%of Ci"ffic;�
Code White File Copy Canary -Inspector's Copy Pink - Finance Copy Gold--Applicant'sRecetpt