HomeMy WebLinkAbout1982-12-09 Permit, Septic System Repair #6899GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
� (6!2)473-7357
CITY PERMIT NO. 6899 1
Date r— _ 7 — do �--
Owner Address -7 S /�.
// L �1
Contractor _ Address 3 Cv kll 44,6 1 /0 i ��`-r1t
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION
Inside Plumbing ( # fixtures )
Water Meter (Size )
Meter # _
Remote #
Municipal Water Connection
❑ Copper r
Fee $
Fee $
Fee $
Municipal Se'.: er Connection Fee $
❑ PVC ❑ Cast 1]
MWCC SAC Charge
ACKNOWLEDGEMENT
Fee $
The undersigned hereby acknowlddges receipt of this limited
Permit, including acceptance of as special information,
terms, conditions or requirements written above. The
undersigned understands and agrees under penalty of law
that this permit is strictly limited to scope to the work,
activity or improvement 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. All work shall be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shall be
abject to inspection, approval or rejection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
S�a11)re f Ap,)l' t��
State License No.
dREPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee
$ C"
Fee
$
Fee
$
I
Fee
$
Fee
$
Other: Fet; $ 1
After -the -fact Investigation Fee $
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $ _5_0 1
Fee $1 e 1
This permit is not valid until the proper fee is paid and
it is o )proved by an authorized City Official.
Signature of City Official
Cote: White --fits Copy Canary —Inspector's Copy Pink -1 inane Copy Gold -Applicant's Receipt