HomeMy WebLinkAbout1985-01-18 Permit, Water Well #7786GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 4-73-7357
CITY PERMIT NO. 7786
Date / /O e 'r I
Owner ry K19,111,
P }7 n / Address e,:>eD(7) CL. 2 i/� Pam) �✓ -
Contractor IQ"Z C�.��n7� � �l i Address � `� %�Qj;;�. L L)Ofn
City License No. 7 L State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures_)
Water Meter (Size—)
M^ter#
Remote #
4ANEW ❑ ADDITION
Fee S
Fee S
Municipal Water Conm_ction Fee S
❑Copper II
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast CI
MWCC SAC Charge Fee S
On Site Septic System
ACKNOWLEDGEMENT
❑ REPAIR
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fire
Sprinkler System (Fire)
- Uther:
Fee S lAfter-the-fact Investigation
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special information,
&arms, conditions or requirements written ar 1. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited in scope to the work,
activity or improvement speclfled: that this permit does
not grant any authority to do work or activities requiring
separate permit approvals, and that this permit does not
grant authority to violate any provision of any City
ordinance or State law, rule or regulation. All work snall be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
subject to inspection, approval or rejection by the City.
Whenever to ordered, the undersigned agrees to correct
any wore found to b- in violation of the conditions of
this permit.
Signature of Applicant
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S - :11 WJ
Fee
S _
Fee
S
Fee
S
Fee
S
Fee
S
Fee
S
Fee
S
Fee S ' -Sol
Fee 53o'J6
This permit is not valid until the proper fee is paid and I
it is approved by an authorized City Official.
Signature of City Official
Code. Mite -File Copy Canary inspector's Copy
Pink - F inance Copy
Gold —Applicant's Receipt