HomeMy WebLinkAbout1986-11-19 Permit, Water Well #8796F
GENERAL PERMIT
CITY OF ORONO
P.O. BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner Y I n Q l p✓ �� n� vYlc�
Con"111" +G) o 1 C,_
City Liceroe No. YL
REMARKS AND SPECIAL CONDITIONS
S ► -k--e (moms -
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures )
Water Meter (Sine )
Meter #
CITY PERMIT N? 8796
Date
Address L�
Address�K �•
City
N
*NEW O ADDMON O REPAIR
Fee $ Water Well
Fee S Mechanical Equipment
Fireplace/Wood Stove
Remote M
Municipal Water Connection
Fee $
O Copper O
Municipal Sewer Connection
Fee S
❑ PVC ❑ Cast ❑
MWCC SAC Charge
Fee S
On Site Spetic System
Fee S
ACKNOWLEDGEMENT
The unlermptned hcrrhy a-krr,piedga rmvipt of thi% Itmtied permit.
trxhaling accelu v tit all %prcial information. tcrmc. oxtdiuom or
reytrremrnl% AMorn ahr,%e Pit utrlmlenr d untimunds and agret,
under penalty of lap that Ihi%permit m Arxll % limited in wow to the work.
a-tmly tx tmfxo%rmem %pwrtrd: that the% permit dtx� not grant any
audxxity todn =t tx allr%tmm retltannit %rparar permit apprmah: and
Ihatthis pemildi sntNgramaudxxitytowilatramprowmrndanyCit}
ttrd.nonm tx Sine lap. rule tx tvTulation UI p(xk ;hall hr done in WWI
txxnpliartce with all City onlinonces. hulthrtg ctxln and/or beam
department rqulatrort%, and %hall ter %t*Wct to inspection. amwmal or
rr)r txvn by the City whene%er .t, ordered. the unlrrvgned aptt-� to
oxmy an% pork found to he to %rt dauttn ttf the condition, ttf this permit
Signature of Applicant
Moving/Lifting Buildings
Land Alteration (Excavation.
Grading, Filling, etc.)
Design Review
Fire
Sprinkler System (Fire)
Other.
After -the -fact Investigation
❑ REMODEL
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee $
TOTAL L
State Surcharge: Fee S -
Total Amount Paid to Ci!y Fee S S.X�
This permit is not valid until the proper fear is paid and it is approved
by an authorimd ON Olfrcial.
Signat of Cltv OlTrctal
Coda. Whir— File Copy Canary--InspeclW% Copy
Pink —Finamv Copy Cxttd-- Applicam's Receipt