HomeMy WebLinkAbout1982-09-24 Permit, Septic System #6825GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner G 0.X A l 1Z M c M 1 // D_n
Contractor Sa Il 1 da.r,_
City License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW
Inside Plumbing ( # fixtures )
Water Meter (Size )
Meter #
Remote #
❑ ADDITION
Fee $
Fee $
Municipal Water Connection Fee $
❑Copper ❑
Municipal Sewer Connection Fee $
❑ PVC ❑ Cast El
MWCC SAC Charge
ACKNOWLEDGEMEN'l
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 tbls permit is strictly limited in scope to the work,
activity or improvement specifted; that this permit does
not grant any authority to do work or activities requiring
separate permit approvals. and that this permit does not
Brant 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
subject to 1pspectlon, approval or rejection by the City.
Wbanever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
ibis permit.
CITY PERMIT NO. 6825,
Date a 4 - -a-
Address !6 a Q /W \i/r`,F1, '
Address '-� ` /D 0 '." /079-t
State License No.
:EPAI R
On Site Septic System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Other:
After -the -fact Investigation
TOTAL
State Surcharge:
Total Amount Paid to City
Fee
$ 60
Fee
$
Fee
$
Fee
$ —
Fee
Fee
g
Fee
$
Fee I I S'0
Fee $ Ad- S'o
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
Code: White - file Copy Canary --Inspector's Copy Pink- Finance Copy Gold Applicant's Receipt