HomeMy WebLinkAbout1983-05-26 Permit, Move Cabin on Lot #7004GENERAL PERMIT
CITY OF ORONO
■U.
CITY PERMIT NO.7004
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Date,
Owner T)/lUIi4
Contractor
City License No._________________
Address.
Address
3l7S
C-lnAiU A/ft^
State License No.
ri:marks and special conditions
^vctcq-/
PERMIT TYPE AND FEE:
Inside Plumbing ( # fixtures.
Water Meter (Size____)
Meter #__________
□ NEW □ ADDITION
_) Fee $________
Fee $________
Remote #
Municipal Water Connection
Q Copper ri
Fee $.
Municipal Sewer Connection
□ pVC DCast Q
Fee $.
MWCC SAC Charge Fee $.
□ REPAIR
On Site Septic System
Water Well
Mechanical Equipment
Moving/Lifting Buildings
Fee $.
Fee $.
Fee $.
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee $ go
Fee $--------------
Other:,
After-the-fact Investigation
Fee $,
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 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 anv City
ordinance or State law, rxUe or regulation. All work shall be
done in strict compliance with all City ordinances, 'a-..Uding
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.
Signatu of p a
A //
/I
TOTAL
State Surcharge:
Total Amount Paid to City
Fee $
Fee S fiO »
I
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signature of City Official
Code: White-File Copy Canary - Inspector’s Copy Pink- I'inance Copy Cold-Applicant’s Receipt
BS i