HomeMy WebLinkAbout1985-11-12 Permit, Septic System #8177GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(Al2) 473-7357
Owner
Contras
City Li
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 8177
Date X
Address
Address
State License No.
PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) Fee S IWater Well Fee S
Water Meter (Size—)
Meter #
Remote
Fee S
Municipal Water Connection Fee S
❑Copper rl
Municipal Sewer Connection Fee S _
❑ PVC ❑ Cast Q__
MWCC SAC Charge Fee $
On Site Septic System Fee S
ACKNOWLEDGEMENT
The underslpted hereby admowisddss receipt of this limited
permit, indudktg acceptance f all special Information.
terms. conditions at requirements written above. The
usdenis"d understands and apses under penalty of law
that thls permit to strietin Waited in scope to the work.
activity of improvement specified; that WAS permit does
not pant any authority to do work or activities requiring
.atMW permit approvals; and that thls permit does not
pot suWad" to violate any provision of any City
egftnanee or •fete law. rule or regulation. Ali work shall be
dew In etdet eempllanoe with all City ordinances, building
Bodes and/or hssith department regulations. and sball be
sabint to " s , tiont, approval at relection by the City.
whenever so ordered, the undersigned agrees to cornet
any work found to be in violation of the conditions of
SiBna re of Applicant
aw"..
Equipment
/Lifting Buildings
Fee S
Fee S
Land Alteration (Excavation, Fee S
Grading, Filling, etc.)
ire Fee S
rinkler System (Fire)
fter-the-fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S
Fee S
Fee S
Fee
Fee
s
s
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature/f City
Code: WhIM--File Copy Canary Inpactor's Copy Pink -F'inatx;e Copy
Grid -Applicant's RaceW