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
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Owner L
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Address
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City License No..r\Ot
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REMARKS AND SPECIAL CONDITIONS
State License No.
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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