HomeMy WebLinkAbout1987-06-12 Permit, Water Well #9056I
GENERAL PERMIT
CITY OF ORONO
OwTicr
RO. BOX 66
CRYSTAL BAY. MINNESOTA 5532^
, (612)47.1-7357
CITY PERMIT N9 9056
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hr:-------------------------------------------------- Address
Contractor ! <3 S:> Address ________________________
City License No. ------_________________________________ City
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE:
Inside Plumbing (Kfixtures___)
NEW □ ADDITION □ REPAIR
Fee $
Witer Meter (Size.
Meter#___
-)Fee $
Remote#
Munidpal Wiier Connection
D Copper D ____
Fee S
Municipal Sewer Connection
□ PVC □ Cast □
; MWee SAC Charge
On Site Spetic System
Fee S
Water Well
Mechanical Equipment
Fiieplace/Wcxxl Stove
Moving/L'Ding Buildings
Land iteration (Excavation.
Grading. Filling, etc.)
Des^ Review
Fire__________________
□ REMODEL
Fee S 3^ $:^
Fee S_________
Fee S _________
Fee $ _________
Fee $
Fee $
»
Sprinkler Svstem (Fire)
Other: ____________
After-the-fact Investigation
Fee S
Fee S
Fee $
Fee S
Fee $
Fee $
ACKNOWLEDGEMENT
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Signature of Applicant___—^^ *
TOTAL
Slate Surcharge:Fee S
Total Amount Riid to City
ThLs permit is not valid until the proper fee is paid and it is approved
by an authorized City OITicial.
Signature of Cits Oflicial , ^
Cixlc Whin- FilcCiipi Canari Impcctnr'i Cop)Pink Finamv Cnpv Gofcl- Applkanfs Roxipt