HomeMy WebLinkAbout1986-02-13 Permit, Water Meter #8340GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY, M1NNESOTA 55323
(612) 473-7357
CITY PERMIT NO. 8340
Date
Owner Address afluv nn�-- c'i
Contractor /l Address qy3(�, � � P
��v M
City License No. _ State License No. —
REMARKS AND SPECIAL CONDITIONS
PERMITTYPE ) E: ❑ NEW ❑ ADDITION
Inside PlumbingWixtures_) Fee S
Water Meter (SizN q � Fee S
Meter li pg 3 / 09 T
Remote #_0
Municipal Water Connection Fee S _
❑Copper Q_ _ -
-Municipal Sewer Conne, tion Fee S
❑ PVC ❑ Cast n
MWCC SAC Charge Fee S
On Site Septic System
ACKNOWLEDGEMENT
Fee S
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of s11 speea .1 Information,
terms, conditions or requirements •.ritten above. The
undersigned understands and Ggreet under penalty of law
that this permit is strictly limited Li scope to the work,
activity �r imr ovement speufled: the this permit does
not grant any authority to do war& or activities requiring
separate permit approvals; wid that this permit does not
Rant authoritY to v!olate any provial on of any City
ordinance or State law, rule or regulation. All work shall be
done in strict compliance with all City ordinances, building
codas and/or health department regulations, wtd shall be
suh►ec, to inspe^.tion, approval or rejection by the City.
Whenever so ordered, the ,.ndersigned agrees to romct
.nv work found to be in lioiation u! the conditions of
this permit.
Signature of Ap/plicant
-- —
❑ REPAIR
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fire
prinkler System (Fire)
Fee
S
Fee
S
Fee
S
Fee
S
Fee S
Fee S
--1Other: Fee S
fter-the-fact Investigation Fee S
TOTAL
State Surcharge: Fee S
Total Amount Paid to City Fee S 100
This permit .'_ oio! valid until the proper fee is paid -ind
it is approved by an ,..ihorized City Official.
Signature of City Official
('ode. White- Fite Copy Canary Inspector's Copy Pink --Finance ('op) Gold Appticant's Recsipt