HomeMy WebLinkAbout1986-07-10 Permit, Septic System #8556GENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
CITY PERMIT NO.8556
Date / 0 - ^ Cg>1
Owner Jr>Krv rv'l'
Contractor,El ElAsLli
Address.
Address
l^lnO ^^0 y)Ot\ OjooJE Q.
City License No..State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing (Ifixtures—)
Water Meter (Size__)
Meter#______________
ii
NEW □ ADDITION □ REPAIR
Remote #.
Municipal Water Connection
O Copper ri
Municipal Sewer Connection
□ pVC DCast Q
MWCC SAC Charge
On Site Septic System
Fee $
Fee S
Fee $
Fee S
Water Well
Mechanical Equipment
Moving /Lifting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Fee S
Fee S '7'K.OC)
Fire
Sprinkler System (Fire)
Other:_____________
After-the-fact Investigation
Fee S
Fee $
Fee $,
Fee $.
Fee $.
Fee S.
Fee $
Fee S
ACKNOWLEDGEMENT
Th« undeniBned hetcby aclmowlcdtei receipt of thU limited
permit, includint acceptance of aU 9ecial Information,
termt, conditions or requirements written above. The
undersiBned understands and adrees under penalty of law
that this permit is strictly limited in scope to the work,
acUvity or improvement specified: that this permit does
not Bnuit any authority to do work or activities requirinB
separate permit approvals: and that this permit does not
Brant authority to violate any provision of any City
ordinance or State law, rule or reBulaUon. All work riiall be
done In strict compliance with all City ordinances. buildinB
codes and/or health department reBulalioiu. and shall be
subject to Inspection, approval or rejection by the City.
Whenever so ordered, the undersiBned aBrees to correct
any work found to be in violation of the conditions of
this permit.
clicantf ApSiifnatu
A.
TOTAL
State Surcharge: Fee S ^ *???
Total Amount Paid to City Tee S
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signaturi^f City Official
Code: White-I Uc Copy Canary - Inspector’s Copy Pink-Finance Copy Gold-Appbcant's Receipt