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HomeMy WebLinkAbout1985-05-13 Permit, Septic System #7916GENERAL PERMIT CITY OF ORONO CITY PERMIT NO.7916 P.O.BOX 66 CRYSTAL BAY, MINNESOTA 55323 (612)473-7357 Date I Owner L Con tractor ^ -fiAcajdtij. / Address Address City License No..r\Ot /y\^0 REMARKS AND SPECIAL CONDITIONS State License No. \ j li PERMIT TYPE AND FEE: Inside Plumbing (#rixtures__) ) NEW □ ADDITION □ REPAIR Water Meter (Size Meter#___ Fee S Fee S Remote #, Municipal Water Connection n Copper r~i Fee S Municipal Sewer Connection □ pVC DCast Q MWCC SAC Charge On Site Septic System Fee S Fee S - Fee S Water Well Mechanical Equipment Moving /Lifting Buildings Land Alteration (Excavation, Grading. Filling, etc.) Fee S Fee $ Fee S. Fee S. Fire Sprinkler System (Fire) Other:_____________ After-the-fact Investigation Fee $. Fee S. Fee S Fee S ACKNOWLEDGEMENT The undertiined 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 Sute 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 %1olation of the conditiotu of this permit. TOTAL State Surcharge: Total Amount Paid to City Fee n . SO Fee sZSl^ Signature of Applicant . This permit is not valid until the proper fee is paid and ^t is approved by an authorized City Official. Signaturelature^City Official Code. Wliiit-File Copy Canaiy Inspector’s Copy Pink-l inancc Copy Gold-Applicant’s Receipt