HomeMy WebLinkAbout1985-07-23 Permit, Septic System #8001GENERAL PERMIT
CITY OF ORONO
CITY PERMIT NO.
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Date.
8001
7'23-3ir
Owner M. £>
/A ) i /vjContractor.
Address.
Address tPfir^
City License No..State License No.
REMARKS AND SPECIAL CONDITIONS
'TjO^'s . /C>t>0 JS-C.
/-
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PERMIT TYPE AND FEE: ^cTnEW □ ADDITION □ REPAIR
Inside Plumbing (Ifixtures__)
Water Meter (Size.
Meter#___
.)
Fee S
Fee S
Remote #.
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Municipal Water Connection
n Copper Q___
Fee $
Municipal Sewer Connection
□ pVC DCast Q
MWCC SAC Charge
On Site Septic System
Fee S
Fee S
Fee S_r2S:
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee S
Fee $
Fee $.
Fee $.
Fire
Sprinkler System (Fire)
Other:_____________
After-the-fact Investigation
Fee $,
Fee $.
Fee $
Fee $.
ACKNOWLEDGEMENT
Th« undanicncd hmby acknowladdM nccipt of this UmiUd
psnnlt. taeludliig oeetptMico of sU spscial Infoimatfon.
toms, eondlilons or rsqulrtnmts wdtttB ahovo. Tht
undtnlciMd undtnUnds and avaaa undar panalty of law
that thla paimlt U strictly United In aeopo to tha work,
activity oc bnprovamant vaelllad: that thla pamlt docs
not grant any authority to do weak or aetMtlos requiring
saparau parrot approvals: and that Uds permit dc<w not
grant authority to violate any provision of any aty
ordinance or State law. rule or regulation. All work shall be
doiM In strict compliance with aU aty ordlnancas. building
codes and/or health department regulattons. and shall be
aublect to Inspection, approval or tejeetton by tha aty.
Whenever so ordered, the underrigned affeea to correct
any work found to be In violation of the conditloBs of
thle permit
Signa of Applicant/
m
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $.
jro
Fee
sx>
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatur&«fCity Official . /
Code: White-File Copy Canary-Inipector’i Copy Pink-Finance Copy Gold-Applicant’s Receipt
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