HomeMy WebLinkAbout1985-09-16 Permit, Sewer & Water #8088GENERAL PERMIT
CITY OF ORON 0
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
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Owner00_,�o
Contractor I) 1 �l
CITY PERMIT NO. 8088
Date_?- ./ �/ 6'5-
Address �� t✓�
Address
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City License No._ C)l0z�_ _ — State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE:
Inside Plumbing (#fixtures_)
❑ NEW ❑ ADDITION
Fee C
Wader Meter (Size_) Fee S
Meter #
Remote#.
Muni6pal Water Connectio Fee S 1�U• (
❑Copper-u►,K �r SyAs
Municip 1 Sewer Connection Fee S �'y�
PVC ❑ Cast ❑,_
MWCC SAC Charge Fee S
On Site Septic System Fee S
ACKNOWLEDGEMENT
The undersigned hereby acknr -edges receipt of this limited
Permit. including acceptance of all special information,
terms, conditions or requirements written above. The
undersigned understands and agrees under pe^alty of law
that this permit is strictiy Urn in scope u, the work,
activity or improvement specified: that this permit does
not grant any authority to do work or activities requiring
separate perm approvals; and that this permit does not
grant author ; .t Oulate any provision of any City
or"t "Mee or State law, Jule or regulation. AU work shah be
dons 'n strict compliance with all City ordinances, hu-i ding
cod" and/or heath department regulations, and shall he
abject to lnspecti.,n, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work hound to be In violation of the conditions of
this permit.
Signature f Appli%c•�fit
Code White File Copy t anary Inspector's Copy
❑ REPAIR
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fei,
Fee S
Ft'; S
Fee $ _
Fire Fee $
System (Fire)
r-the-fact Investigation
TOTAL
State Surcharge:
Fee S
Fee S
Fee S
Fee S
Total Amount Paid to City Fee S (a /
This permit is not valid until the proper fee L t and
it is approved by an authorized City Official.
Sigma re of City O icial
Pink -Fbmm Copy Gold -Applicant's Receipt