HomeMy WebLinkAbout1983-10-24 Permit, Rep. Water Well #7215GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
CITY PERMIT NO. 721 �
Date
Owner / t e I)L Address �2720 -Cox ST
Contractor STL� Address
City License No.
State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDIVON ❑ REPAIR
Inside Plumbing ( # fixtures ) Fee $
Water Meter (Size )
Meter Al
Remote #
Fee $
Municipal Water Connection Fee $
❑ Copper ❑
Municipal Sewer Connection Fee $
❑ PVC ❑ Cast Q
MWCC SAC Charge 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 t+ermit does
not grant any authority to do work or activities requiring
separate permit approvals; and that this permit does not
grail authority to violate any provision of any City
ordinance or SSate law, male or regulation. All work shall be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and ahall be
subject to inspection, approval or resection by the City.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of Ap t 1114
On Site Septic System Fee $
Water Well Fee $ 210, 00
Mechanical Equipment Fee $
Moving/Lifting Buildings Fee $
Land Alteration (Excavation, Fee $
Grading, Filling, etc.)
Other: Fee $
After -the -fact Investigation Fee $
20oa
f
:'OTAL
State Surcharge: Fee $ S U
Total Amount Paid to City Fee $
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
vial
Code: White --File Copy Canary- Inspector's Copy Pink- I inance Copy Gold Apph"rit's Receipt