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HomeMy WebLinkAbout1986-08-25 Permit, Water Well #8635GENERAL PERMIT CITY OF ORONO P.O. BOX 66 CRYSTAL BAY, MINNESOTA 55323 (612)473-7357 owner 4 /2n o C'*fo ra ZL" Cattnkor 454-ei)ens ! 11 City Limnse No. /.` RFINARKS AND SPECIAL CONDITIONS PERMIT TYPE AND FEE bWk Plumbim Wfixtures ) Water Meer (Size ) Meter p Remote a Municipal Wake Correction O Copper O Mw icipd Sewer Correction O PVC O Cast O MWCC SAC Chaise On Site Spetic System ACKNOWLEDGEMENT NEW Fee S Fee S Fee S Fee S Fee S Fee S The utatkrsWted hereby akormakdpts reonpr d IN% limited Mmit. ilkludwilt amnft tcc car ON special inkxrnatim. term., taxdAKN% or rryurentertea wtiske apse nit tatder%*wd uralerwrxk and apm under prnaky d law drat dtis permits imily limited in nnpr to for iAmli. ulkity 4r toW „em m 4xviliied that this permit dtx% mA prant any audxxily todo wtrrlt tw aysitia tegtar fq wparaar permit appnnak: and Rini tkispermitdims nnl Er'm aullarxity to syahtr any pnriwm orany Cny ordinam cr State law. ruk tx repulatmi m All sstxk Jell he Jortr in vrct annpw"M with aI Cite tMdinamm hukbng udn and'(x health tkpartmem rquiationK and %W be %utWo to tnspea m. approsal or re)Mron M the City. wherw%cr %, extend. the wakrvltned apm to ctoom am ssork knartd Rohe m the civuloitw%dIhis permit Signature of A^pp-ii-a- nt / CITY PERMIT ND 8635 Date �- ��s -X Address AA . Address60,24,0 t � City O ADDMON O REPAIR Water Well Mechanical Equipment Fireplace/Wood Stove Moving/Lifting Buildings Band Aheration (Excavation. Grading, Filling, etc.) Design Review Fire Sprinkler System (Fire) Other. After -the -fact Investigation TOTAL State Surcharge: ToW Ankwnt Paid to Cloy O REMODEL Fee S 0' Fee S Fee S Foe S Fee S Fee S Fee S _ Fee S Fee S Fee S Fee $ 'so Fee $..� .SD This permit is not valid until the proper, fir is paid and it is approved by an authorized City Olficwl. Signature d City ' I Ctxk: Wfuk. FileCt" Canary Ins(ttiyty'. Clvpy fink Finance Cttpy GoW ArK4%,ani's Receipt