HomeMy WebLinkAbout1985-05-02 Permit, New Water Well #7899GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-735/7
Owner _I C—
Contractor T),�4
City License No.
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 7899
Date
Address Z)/C
Address
State License No.
PERMIT TYPE AND FEE: *NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing 4fixtures_)
Water Meter (Size—)
Meter IF
Remote #
Fee S Water Well
Fee S--- -- Mechanical Equipment
Municipal Water Connection Fee S
❑Copp;r r
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast r_
MWCC SAC Charge
On Site Septic System
ACKNOWLEDGEMENT
oving /Lifting Buildings
Fee
Fee S
Fee S
_ ILand Alteration (Excavation, Fee S
Grading, Filling, etc.)
ire Fee S
rinkler System (Fire)
Fee S _ _ _ __ _ _ 10ther:
Fee 5 IAfter-the-fart Investigation
The undersigned hereby acknowledges receipt of this limited
Permit, including acceptance of all special information,
terns, conditions or requirements written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited in wore to the work,
activity or improvement specified; that this permit does
not past 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. Ali work shall be
done in strict compliance with ail City ordinances, building
codes and/or health department regulations, and shall be
suNet t to lnspecti is, approval or reJection by the City.
Whenever so ordered, the undersigned *pees to correct
any work found to be in .iolatinn of the conditions of
this permit.
Signature: of Applicant ;
TOTAL
Fee S
Fee S
Fee S
State Surcharge: Fee S SO
Total Amount Paid to City Fee S ' S�
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signat o City Official
Code White- Idle Copy (unary Inspector's Copy
Pink -Finance Copy Gold - Appticani'sReceipt