HomeMy WebLinkAbout1986-06-16 Permit, Septic System #8524GENERAL PERMIT CITY PERMIT NO. 85241
CITY OF ORONO �_l�o_
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner aYu C' -e r ( C , ` Address
Contractor % Address i
i
City License No. - t1 State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE.
Inside Plumbing (#fixtures_.)
Water Meter (Size—)
Meter#
Remote
NEW ❑ ADDITION
Fee S
Fee S—____--
Municipal W.tier Connection Fee S —
❑Copper n_
Municipal Sewer Connection Fee 5
❑ PVC D Cast n
MWCC SAC Charge Fee S
On Site Septic System Fee S
ACKNOWLEDGEMENT
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 in 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. AU work shall be
done in strict compliance with aU City ordinances, building
codes and/or 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 o/ the ronditions of
this permit.
Sign re of Applit:ant
61&n
❑ REPAIR
titer Well Fee S
Mechanical Equipment
Fee S
Moving /Lifting Buildings
Fee S
Land Alteration (Excavation,
Fee S
Grading, Filling, etc.)
Fire
Fee S
rinkler System (Fire) Fee S
her:z�T l'.P-in�a-P Fee S J, v j
er-the-fact Investigation Fee S J
TOTAL
State Surcharge:
Total Amount Paid to City
Fee
Fee
S
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatu of City OfficiaY
Code Mile I tic t opy Canary -Inspector's Copy Pink I inance Copy' Cold Applicant's Receipt