HomeMy WebLinkAbout1985-11-14 Permit, Septic SystemGENERAL PERMIT CITY PERMIT NO. 8187
CITY OF ORONO
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357 ^
Owner C;t.l' yl I ti Address ✓�[L'�� l n�LL fiC'/ �•
Contractor f 1 Address
City License No c (C.' I State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: *NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing Ofixtures_)
Water Meter (Size_)
Meter#
Remote 1
Municipal Water Connection
❑Copper 11
Municipal Sewer Connection.
Fee S
Water Well
Fee S
Fee S —__- _
Mechanical Equipment
Fee $
Moving /Lifting Buildings
Fee S
Fee S _
Land Alteration (Excavation,
Fee $
Grading, Filling, etc.)
Fee S _ Ir ire Fee S
❑ PVC ❑ Cast a
MWCC SAC Charge Fee S
On Site Septic System Fee S 100
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special Information,
terms, con.litlons or requirements written above. The
undersigned understands and agrees under penalty of law
that this pe.mlt is strictly limited In scope to the work,
activity or unprovement specified: 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. Ail work shell be
done In strict compliance with all City ordinances, building
codes end/or health department regulations, and shall be
subject to inspection, approval or rslection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
ature of
)rinkler System (Fire)
ther:
fter-the-fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S
Fee S j
Fee $ I
Fee S ' -3
Fee s' �, <o
This permit is not valid until the proper fee is paid and I
it is approved by an authorized City Official.
4
Signature of ty Official
r LLx w,
Code. White file Copp Canary - -Inspector's Copy Pink --Finance Copy Gold -Applicant's Receipt