HomeMy WebLinkAbout1985-10-29 Permit, Septic System #8153GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
CITY PERMIT NO. a
Date / o _ o-) C�_ � (�--
Owner /I Address / po?5 �� X ,Sj
Contractor c 1, Address
City License No. • -�(L� r% State License No.
REMARKS AND SPECIAL CONDITIONS
— / L , O U TlLl) ,( v / — `�) T-Y `, lL ( ; i i, c-) t C t . / L ( i . -\) / *. 71' (A
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IF
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) Fee S Water Well Fee S
Water Meter (Size—) Fee S —_ Mechanical Equipment Fee S
Meter #
Remote # Moving /Lifting Buildings Fee $
Municipal Water Connection Fee S
❑Copper
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast n
MWCC SAC Charge Fee
On Site Septic System Fee S �75 • ��
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 Umited in seope 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 shell be
done In strict compUance with all City ordinances, building
Lcodes and/or health department regulations, and shall be
sck,lect to Inspection. approval or reiectlon by the City.
Whenever to ordered, the undersigned agrees to correct
any work found to be in violation of the conditinns of
this permit.
Signatu of Applicant /
Land Alteration (Excavation, Fee S
Grading, Filling, etc.)
Fire Fee S
Sprinkler System (Fire)
Fee S
ther: Fee S
fter-the-fact Investigation Fee S
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S - 5L' '
Fee S S, '
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signat* of City
Code: White file Copy Canary -Inspector's Copy Pink -finance Copy Gold -Applicant's Receipt