HomeMy WebLinkAbout1987-01-15 Permit, Water Well #8874GENERAL PERMn
CITY OF ORONO
Owner
P.O.BOX66
CRYSTAL BAY, MINNESOTA 55323
r (612)473-7357
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CITY PERMIT N9 8874
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Date
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REMARKS AND SPEOAL CONDITIONS
Address
Address
City -
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PERMIT TYPE AND FEE
Inside Plumbing (#fixtuies —
IMuer Meier (Size-----)
Meter#---------------
-)
^ NEW
Fee S
Fee $
□ REPAIR
Remote#
Municipal Wiler Connection
□ Copper □ -----
Fee $
Municipal Sewer Connection
□ PVC □ Cist □
MWCC SAC Charge
On Site Spetic System
Fee $
□ ADDITION
Witer Well
Mechanical Equipment
Fireplace/Wood Stove
Moving/Lifting Buildings
Land iteration (Excavation,
Grading, Filling, etc.)
Design Review
Fire-------------------------
Fee S
Fee $
ACKNOWLEDGEMENT
The undmiigncd hereby ackmmlcdgcs receipt of this limited permit
including acccpunce of all special information, terms, conditions or
requiremenis written oKwe. The undersigned understands and agrees
under penalty of law that this permit is stnctly limited in scope to the work,
activity ix improvement speciricd: that this permit does not gram any
aulh'wiiy todti w ork or activities requinng separate permit approvals: and
that this permit dc«s ma grant authonty to viohile any provision of any City
ordinance or State law. rule nr regubtion All work shall he done in strict
ctunphance with all City ordinances, building codes and/or health
depanmcnl icgubtionv and shall be subjert to inspection, appnnal or
rejKlion by the City W'henever so ordered, the undersigned agrees to
correct any work found to be in viobtion of the conditions of this permit
S^nature of Applicant
I. ....
□ REMODEL
Fee $
Fee S
Fee $
Fee $
sprinkler System (Fire)
Other ----------------
After-the-fact Investigation
Fee $
Fee S
Fee $
Fee S
Fee $
Fee $
TOTAL
State Surcharge:
Total Amount ftikJ to City
Fee S
Fee $ 30'^^..
This permit is not valid until the p.oper fee is paid and it is approved
by an authorized City Official.
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Code White-File Copy Canary—laspccior’s Copy Pink—Finance Copy Gold—Appiicanfs Receipt