HomeMy WebLinkAbout1983-10-24 Permit, Water Connection #7214GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSI %L BAY, MINNESOTA 55323
612) 473-7357
CITY PERMIT NO. 7214,
Date a - "�_q- 83
Owner IMK li-a-z-KE 1dress ' y3 !
Contractor SuLL% V w.ti S SERtI►CG Address
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE:
1� NEW ❑ ADDITION
Inside Plumbing ( #;;fiixtures
) Fee S
Water Meter (Size1�)
Fee S-75
Meter # 32.-7 46
60
Remote # O 3 A 1 `A
R 9
ter Ccnnection
Milt)Z�
0
_
Fee S0
per n
Municipal Sewer Connection
Fee S
❑ PVC. ❑ Cast
MWCC SAC Charge Fee S
AC'KNu►vLEDGEMENT
The undersigned hereby ackoowledges rec�•ipt of this limited
Permit. including acceptance of all special information.
terms, cunditionq or requirements written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited In scope to the work,
activity or improvement specified: that this permit does
not grant any authority to do work or acpcldes requiring
separate permit approvals. and that this Permit does not
grant authority to violate any prwIsion of any CIts
urdlnance or State law, rule or regulation. All work shell be
dune In strict compilance with all City ordinances, building
codes and/or health department regulations, and shall be
subleet to inspection, approval or relocbon by the city.
Whenever su ordered, the undersigned agrees to correct
any work found to 1w in violation of the conditions of
this permit
Si attire of Applicant
State License No.
❑ REPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee
S
Fee
S
Fee
S
Fee
$-
Fee
S
Other: Fee S _
After -the -fact Investigation Fee S
TOTAL
State Surcharge: Fee S —_5
5a
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.
• �'
Code: White -File Copy Canary - Inspecitors Copy
Pink -Finance Copy Gold --Applicant's keceiF.