HomeMy WebLinkAbout1982-07-27 Permit, Sewer Hook Up #6752GENERAL PERMIT
CITY OF ORONO
CITY PERMIT NO. 6752
Datl' %
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357 Owner Address 7Sk-1-6 / Igf
Contractor J141kUdress t�d
City license No,
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: NEW ❑ ADDITION
Inside Plumbing ( # fixtures )
Water Meter (Size )
Meter #
Remote #
Fee S
Fee $
Municipal Water Connection
Fee S
[]Copper
Municipal ewer Connection
PVC ❑ Cast
MWCC SAC Charge
Fee $
Fee $�
ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special Information,
terms, conditions or requirements 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 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 &hall be
subject 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
thu, permit.
i ature plicant
Code: White --File Copy Canary Inspector's Cope
State License No.
4/7-7
❑ REPAIR
On Site Septic System Fee $
Water Well Fee S
Mechanical Equipment Fee S
Moving/Lifting Buildings Fee S
Land Alteration (Excavation, Fee $
Grading, Filling, etc.)
Other: Fee $
After -the -fact Investigation Fee $
TOTAL
State Surcharge: Fee S
Total Amount Paid to City Fee $ D 5V_
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Si t e of City Official
Pink I inanre l �,pc (,old- Applicant's Receipt