HomeMy WebLinkAbout1982-08-30 Permit, Sewer Connect #6785GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner Zof Qe#6�
Contractor /
City License No.
REMARKS AND SPECIAL CONDITIONS
CITY PERMIT NO. 67851
Date t�7 -3b -0�
Address
Address 1Z W 6 G.• .
itate License No.
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing ( # fixtures ) Fee $ _
Water Meter (Size ) Fee $ --
Meter # _
Remote #
Municipal Water Connection Fee $
❑ Copper ❑
Municipal Sewer C, nnection Fee $
❑ PVC ❑ Cast ❑-
MWCC SAC Charge
ACKNOWLEDGEMENT
Fee $
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 no:
grant authority to violate any provision of any City
ordinance or State law, rule o. regulation. All work &hall 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
this permit.
Siyur � of Ap 'ant
On Site Septic System Fee S
Water Well Fee S
Mech.,nical Equipment Fee $
Mop ing/Lifting Buildings Fee $
Land Alteiation (Excavation, Fee $
Grading, Filling, etc.)
Other:
Fee $
After -the -fact Investigation Fee $
TOTAL
State Surchar ve: Fee $
Total Amount Paid to City Fee S Ot4(2
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Sig lee of City Ic al
t 1 � —
Code. White -Idle Copy Canary- Inspector's Copy Pink -finance Coe; Gold --Applicant's Receipt