1985-12-04 Permit, Water Well #8220

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GENERAL PERMIT CITY OF ORONO P.O.BOX 66 CRYSTAL BAY, MINNESOTA 55323 (612) 473-7357 Owner Contractor <L> ,r1 City 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 Water Connection Fee ❑Copper Q Municipal Sewer Connection Fee S ❑ PVC ❑ Cast n MWCC SAC Charge Fee S On Site Septic System ACKNOWLEDGEMENT CITY PERMIT NO. 8220 Date Address _ Address State License No. ❑ REPAIR (Water Well Mechanical Equipment Moving /Lifting Buildings Land Alteration (Excavation, Grading, Filling, etc.) Fire Sprinkler System (Fire) her: Fee S (After -the -fact Investigation 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 Is-, rule or regulation. All work shall be done in strict compliance with all 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 of the conditions of this permit. Signature of Applicant TOTAL Fee S Fee S Fee S Fee S Fee S,_ Fee S Fee S Fee S State Surcharge: Fee S_�)n Total Amount Paid to City Fee S_ This permit is not valid until the proper fee is paid and it is approved by an authorized City Official. Signature of City Official Code White -File Copy CAnar) Inspector's Copy Pink -Finance Copy Gold —Applicant's Receipt