HomeMy WebLinkAbout1985-11-14 Permit, Septic System #8188GEYERAL PERMIT CITY PERMIT NO. 818�
CITY OF ORONO
P.O.eOX 66 Datc
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner 1 ► "�_� ti Address 7.� - 14-k
Contractor ) ' C' Address
i
City License No. �� C' L� State Licensc No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ,;q NEW ❑ ADDITION ❑ REPAIR ''
i Inside Plumbing (#fixtures_)
Fee
S
Water Meter (Size_)
Fee
S
Meter#
Remote -
Municipal Water Connection
Fee
S
❑Copper
Municipal Sewer Connection
Fee
S
❑ PVC ❑ Cast
MWCC SAC Charge
Fee
S _ _
On Site Septic System
Fee
$�l
ACKNOWLEDGEMENT
E The undersigned hereby acknowledges receipt of this limited
permit, Including acceptance of all special Information,
terms, conditions or requirements wdtlen 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 activities requiting
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. AO work shall be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
abject to inapeetion, approval or election by the City.
Whenever so orderedthe undersigned agrees to correct
i any work found to w In violation of the conditions of
this permit.
Si ; bf ' •• nt
n
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fire
Sprinkler System (Fire)
Dther:
After -the -fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee
S
Fee
S
Fee
S.
Fee
S
Fee S
Fee S
Fee S
Fee S
Fee S ���
Fee S S, 2
This pefmit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatury of City
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Code: White-- File Copy Canary --Inspector's Copy Pink - Finance Copy Gold -Applicant's Receipt