HomeMy WebLinkAbout1985-08-22 Permit, Septic System #8057 (cancelled)GENERAL PERMIT CITY PERMIT NO. 8057-
CITY OF ORONO Date
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner �- Mn-%�_ Address
Contractor Address ��d b / l7ZLJ� 8/,��(V
City License No. .mil State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE:
`r,Ll NEW
❑ ADDITION
❑ REPAIR
Inside Plumbing (##fixtures_)
Fee
S
Water Well
Fee
S
Water Meter (Size—)
Fee
S __
Mechanical Equipment
Fee
S
Meter#
Remote#
Moving /Lifting Buildings
Fee
$
Municipal Water Connection
Fee
S
Land Alteration (Excavation,
Fee
S
❑Copper Q
Grading, Filling, etc.)
Municipal Sewer Connection
Fee
S _
Fire
Fee
$
❑ PVC ❑Cast
0_
Sprinkler System (Fire)
Fee
S
MWCC SAC Charge
Fee
$_ --
Other:
Fee
S
On Site Septic System
Fee
S 57 00
After -the -fact Investigation
Fee
S
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
Permit. including acceptance of all special information,
terms, conditions or requirement 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 specined: that this permit does
not grant any authority to do work or activities requiring
separate permit approvals; and that this permit does not
Pant authority to violate any proAdon of any City
ordinance or State law, rule or regulation. All work stall be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shell be
sublect to inspection, approval or refection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of
TOTAL
State Surcharge: Fee I _ �y
Total Amount Paid to City Fee $1
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature 9PUity Official
Code: White cy Canary-tnspector's Copy Pink - Finance Copy old -Applicant's Receipt