HomeMy WebLinkAbout1985-06-20 Permit, Septic System #7959GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
to; 11) 471-73i 7
Owner
Contras
City Li
REMARKS AND SPECIAL
CITY PERMIT NO. 'MIN
Address
Address
State License No
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (Mixtures_)
Water Meter (Size—)
Meter #
Remote#)
Fee S
Fee S __ __
Municipal Water Connection Fee S _
❑Copper F1
Municipal Sewer Connection Fee S --
❑ PVC Cl Cast n
MWCC SAC Charge Fee S
On Site Septic System Fee S
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit, including aeeeptence of all special information.
terms, condition or requirements written above. The
undersigned understands and agrees under penalty of law
that " petntit is strictly limited In Scope to the work.
Wdvity air improvement specified: that thle es pot do
not gmt any authority to do work or activities requiting
$operate permit approval; and that ads permit does not
grant authority to violate any provision of any City
ordinance or State law. rule or regulation. Ali work .ball be
out in strict compliance with all City ordinances. building
nodes andlor bealth departmen! regulations. and shall be
subject to hnpoetlon, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be In violation of the eonditlons of
this permit
Simature of Applicant
ZI,Uff r7a'a,
ater Well
Mechanical Equipment
Moving /Lifting B!iildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fire
rinkler System (Fire)
her:
fter-the-fact Investigation
TOTAL
Fee S
Fee S
Fee S
Fee S
Fee $
Fee S
Fee $
Fee S
. _V
State Surcharge: Fee S
Total Amount Paid to City Fee S
This permit is nc valid until the proper fee is paid and
it is approved by an authorized City Official.
Si pl of City Officl I
Code. White -File Copv Canary - Inspector's Copy Pink -Finance Copy Gold -Applicant's Receipt