HomeMy WebLinkAbout1985-06-20 Permit, Septic System #7958GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
12) 473-7357
OwnerU e
Contractor
City License No.�
REMARKS AND SPECIAL CONDITIONS
11r1A i/
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures_)
Water Meter (Size—)
Meter#
Remote #�
CITY PERMIT NO. 7958
Address
• ■[�-G� _
State License No.
❑ NEW ❑ ADDITION ❑ REPAIR
Fee S lWater Well
Fee S Mechanical Equiprnen'
Municipal Water Connection Fee S
❑Copper n
Municipal Sewer Connection Fee S
❑ PVC ❑Cast n
MWCC SAC Charge
On Slit. Septic System
ACKNOWLEDGEMENT
Fee S
Fee S
The undersigned hereby acknowledges receipt of this limited
permit, "icluding acceptance of all special information,
terms, conditior or requirements written above. The
undersigned -mderstands and agrees under penalty of law
that this permit is strictly limited in scope to the work,
activity or improvement specified; that this permit duos
not grant any w.thority to do work or activities requiring
separate permit approvals; and that this permit does not
grant au hority to violate any provision of my City
ordinance or State law, 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
subiect to inspection, approval or refection by the City.
Whenever su <udered, the undersigned agrees to correct
any work found to be in �Ioladon of the conditions of
this permit
Siknatury of Applicant
/Lifting Buildings
nd Alteration (Excavation,
Grading, Filling, etc.)
System (Fire)
TOTAL
Fee S —
Fee S _
Fee $_
Fee S_.
Fee $_
Fee S_
Fee S
Investigation Fee S
' 5-0State Surcharge: Fee S --�77
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.
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