HomeMy WebLinkAbout1986-10-29 Permit, New Water Well #8762GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
YSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner .J/"Oo
Contractor
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE --
Inside Plumbing (#fixtures —)
Water Meter (Size —)
Meter All _
Remote a
Municipal %ter Connection
❑ Copper ❑
Mwwpal Sewer Connection
❑ PVC ❑ Cast ❑
MWCC SAC Charge
On Site Spetic System
ACKNOWLEDGEMENT
' iNEW
CRY PERMIT N? 8762
Date
Address �It3 1ck e t-f Z—k Z9/
c
Address
City fo/�
❑ ADDITION
Fee S I Water Well
Fee S
Fee S
Fee S
Fee S
Fee S
The urdenrltnel hcreh� acktkmkdKc. ramp t4 this lrm,W mrim
trttltahrtlt atxeptante of all %Paul rlornuutm, term%. tondntom ,r
reytmrenwM% wnttrn tlxnc Tht unlentEned unlrnunth and ar rt,
utdn rwmh% of laa tbt this mmtl n orm1% hmtred to vorw to thr work.
utt%tty tr rmprowment %pYdted. that tht% prmrt &r% n,t grant an,
authonty tod wtxk or attttit" mgwnryt,rparat fermnap{uo,ak and
thatthisPrrmtrtk,nnNRunauthont%tobrielramp")% mn4an%0t%
txdoanY tw Stair law. rule or regulatr„n .AD Atwk %hall N. tkmr to vrxt
awnPlamv with all ('m% ,ndimmrs. Ixukhrip ttixka ant m health
dt7anment repulatttm%. artd %hall he .utlett ap , tmnutm. appomal or
relatmm h% thr ('n% N'henrtrr m, ordered. the unkrmrrw d ajrrrrn to
torrett am work found to hr m ,aaatt,m,4 the c,rdtuom„ l this rwrmm
Signature of Applicant
❑ REPAIR
Mechanical Equipment
Fireplace/Wood Stove
Moving/lifting Bwldings
Land Alteration (Excavation,
Grading, Filling, etc.)
Design Review
Fire
Sprinkler System (Fire)
Other.
After -the -fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
❑ REMODEL �.,)
Fee S vU
Fee S
Fee $
Fee S
Fee S
Fee S
Foe S
Fee S
Fee S
Fee S
Fee S ' -se)
Fee S
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
-44we of City Official
C'ruir U hrle File Cop% Canan Inch tiux'% Copy hnk -- Finarfa Cop% UQ - Applicant's Raetpt