HomeMy WebLinkAbout1986-06-04 Permit, Septic System #8499GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473.7357
Owner
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Contractor
City License No.
REMARKS AND SPECIAL, CONDITIONS
CITY PERidI1 NO 8499
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Date Z_
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Address
State License No,
PERMIT TYPE AND FEE: ❑ NF.W ❑ADDITION 10 REPAIR
Inside Plumbing (#fixtures ) Fee S
Water Meter (Size
Meter #
Remote #—
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Fee S _ _ - — I
Municipal Water Connection Fee S
❑copper
Municipal Sewer Connection
❑ PVC ❑ Cast
MWCC SAC Charge
On Site Septic System
ACKNOWLEDGEMENT
Fee S __
Water Well
Fee
S
Mechanical Equipment
Fee
S
Moving /Lifting Buildings
Fee
S
Land Alteration (Excavation,
Fee
S
Grading, Filling, etc.)
Fire
Fee
S
Sprinkler System (Fire)
Fee
S
ther:
Fee
S
1
Fee $ :�--) * � After -the -fact Investigation Fee S
The undersigntd 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 not
grant 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 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.
S' attire of Applicant
Code. White -File Copy Canary --Inspector's Copy
TOTAL
State Surcharge:
Total Amount Paid to City
Fee S #5C7
Fee S�.
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatu of City Official
Pink —finance Copy Gold --Applicant's Receipt