HomeMy WebLinkAbout1987-02-10 Permit, Abandon Well #89041
GENERAL PERMIT
CITY OF ORONO
Owner
P.O. BOX 66
CRYSTAL BAY. MINNESOTA 55323
(612)473-7357
CITYPE:RMIT N9 8904
jL-IO-gODate
Address
Contract
City License No.
Address
/5 -ZV-:
ns'
City OC -4L-^r-I
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE:□ NEW □ ADDITION □ REPAIR □ REMODEL
Inside Plumbing (((fixtures-----)Fee $
>\^ter Meter (Size
Meter#___
)Fee $
Remote #
Municipal V^ter Connection
□ Copper □ -----
Fee $
Munidpal Sewer Connection
□ PVC □ Cast □
MWCC SAC diarge
On Site Spetic System
Fee $
Fee $
Fee $
Water Well
Mechanical Equipment
Fireplace/Woixl Stove
Moving/Lifting Buildings
Land Alteration (Excavation.
Grading. Filling, etc.)
Design Review
Fire__________________
Fee $
Fee %
Fee $
Fee $
Fee $
Fee $
Fee $
Fee $Sprinkler System (Fire) ----------------------
Othen LO^/ Fee $ SO
After-the-fact Investigation Fee $ --------------
ACKNOWLEDGEMENT
The uinlervigiKiJ hea’b> ackiutwictiges avcipi this limiled pcmiil.
including accepunev of all spixial informaiion. terms, conditions or
requinrinenis wntten aKtve. TTic undersigned understands and agrees
under penalty of lass that this permit is strictly limited in h,o|v to the ssork.
activity or improvement specified; that this permit divs not grant any
authoritv todo vs ork or activities requiring separate permit approvals; and
that this permit does not grant authority to violate any provision of any City
ordinanev or State lavs, rule or regukition All work shall he done in strict
cumpliance with all City oiilinancc>. building codes and or health
department regulations, and shall be sub|cxl to inspection, approval or
rejcMion hv the (its Whenever so ordered, the undersigned agrees to
correct any work found to be in sii'.lation of the conditions of this permit.
Signature of Applicant.
TOTAL
State Surcharge:Fee $*>\5^
Total Amount Piid to City Fee $
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
Signature of City Officialnature ol city wiiic.iai ^ ^
Gxto; While lileGipv Canary Inspcdsir% Copy Pink I'inana' Copy Cisild Applicant's Rcxvipi
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