HomeMy WebLinkAbout1986-12-19 Permit, Sewer Connect #8845GENERAL PERNIIT
crrY OF ORONO
P.O. BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner
Contrat:tor. Lai
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: NEW
Inside Plumbing (MSxtures ) Fee S
Water Meter (Sire ) Fee S
Meter #
CITY PERMIT N? 8845
Date - — Alt
Address Z2 �f l�X, k
Address /< l ry 1 �,I!� 6 1114f—
City f
O ADDITION 0 REPAIR O REMODEL
Remote p
Municipal Water Connection Fee S _
f] Copper O
Municipal Sewer Connection Fee S 5 LiL
O PVC * Cast O
MWCC SAC Charge Fee S
On Site F; .'i, System Fee S
ACKNOWLEDGEMENT
The unik1%kroed hereby ttckno%ktlgcs reLvip d this limited permit.
tniudnttg aurlxamv d all special inkwmmxwt. terms. cttnlrliorcs tw
reytrremeruc %mien abmr. The undemittrnd understands and agrees
under penalty tdta% that this permit is Vridh hmiard in Volt Io the work.
attisily tw tmprosrmrm specified: that this permit dtte, ntl grant am
autldmty ludo wtwk tw actisitirs rrquinng xparate permit approsals: and
Oral this prrtnil dace r%4 gram audw my to sioiate am prosi%ion d any City
twditamr tw State law. rule or regulatitm All wtwk shall Ise dime in strict
comril.ani with all Cay twdirrmr, hwiding ndles and tw health
department rrguhatxwn, and .hall he suhjmi to inspection. approsal of
rciectxxt by the City Whensrr sit ordered. the unkrvgned agrees to
owmt any wtwk f4wind to be in siolautm of the ctwtthoorn of this permit
Si .<�of Applicant '
�--e c-
Water Well
Fee S
Mechanical Equipment
Fee S
Fireplace/Wood Stove
Fee S
Moving/Lifting Buildings
Fee S
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee S
Design Review
Fee S
Fire
Fee S
Sprinkler System (Fire)
Fee S
Other.
Fee S
After -the -fact Investigation
Fee S
TOTAL
State Surcharge:
Fee S
• JV
Total Amount Paid to City Fee $2t
�t�#J1�X3
This permit is not valid u-ttil the proper fee is paid and it is approved
by an authorized City Official.
Signature of City Official
Ctxk' Whitt, Filr Copy Canary InsMior's Copy Ping Finance Copy Cxslrl- Aprrlicant's Rempt