HomeMy WebLinkAbout1985-01-08 Permit, Water Well #7773GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner �I PJrr �./ �� 7L;,Z%S Address
Contractor T)r_4 "l jr� Address
CITY PERMIT NO.
Date
11/5/ 7�,c
City License No. f� State License No. -
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: X-PEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (►fixtures_) Fee S
Water Meter (Size _)
Meter#
Remote
Fee S
Municipal Water Connection Fee S
❑Copper
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast n
MWCC SAC Charge Fee S
On Site Septic System
ACKNOWLEDGEMENT
ater Well
Mechanical Equipment
/Lifting Buildings
Land Alteration (Excavation,
Grading. Filling, etc.)
Fire
Sprinkler System (Fire)
then.
Fee 5 lAfter-the-fact Investigation
The undersigned hereby acknowledges receipt of this limited
permit. Including acceptance of all special information,
terms, conditions or requirements wditen 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. Ali 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 violeuon of the conditions of
this permit.
Signature of A licant
TOTAL
7773-
Fee 5
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
e
State Surcharge: Fee $
Total Amount Paid to City Fee S &01 5-0-
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatuu of City Of cial
Code. White -File Copy Canary Inspector's Copy Pink- Finance
Gold -Applicant's Receipt