HomeMy WebLinkAbout1985-12-04 Permit, New Water Well #8217M ,
GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 5532-3
(612) 4733-7357
Owner l—Qnc _
Contrdctor 5 1,4-6-1. _
City License No. C:?>vn
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 8217
Date
Address -7�2� ' 'ti a , Or .
Address r 1 B oy 7-5— kcr-1-. f d
State License No.
PFRMIT TYPE AND FEE: )0 NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) Fee S
Water Meter (Sire _)
Meter #
Remote
er Well
Fee S IMechanical Equipment
Muni —pal Water Connection Fee S
❑Copper 13 _
Municipal ,ewer Connection Fee a _
❑ PVC ❑ cast G—_
MWCC SAC Charge Fee S _.
On Site Septic System
ACKNOWLEDGEMENT
Fee S
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special Information,
terms, condaoos or requirements anitten above. The
undersigned understands and agrees under penalty of law
that this permit is strtcUv limited In scope to the work,
activity or improvement specified; that this permit does
not grant any authority to do work or activtties requiring
separate permit approvals; and that this permit does not
grant authority to violate any pro,islon of any City
ordinance or State law, rule or regulation. All work shall be
done In strict compliance with all CAv ordinance►, building
codes andlor health department regulations, and shall be
subject to Inspection, approval or rejection by the City.
Whenever at) ordered. the undersigned agrees to correct
any work found to be in volauon of the condluons of
this permit.
Signature of Applicant
P�
Code: White -FUeCopy Canary-Inapector's Copy
oving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee S �•
Fee $
Fee S
Fee $
re Fee $
rinkler System (Fire) Fee s
her: Fee S
e-fact Investigation Fee S
TOTAL
State Surcharge: Fee $ ' �t�
Tutal Amount Paid to City Fee $ '30•
This permit is not valid until the proper fee is laid and
it is approved by an authorized City Official.
Signature of City Offi
Pink -Finance Copy Gold-AppBaftt's Receipt