HomeMy WebLinkAbout1985-08-06 Permit, Land AlterationGENERAL PERMIT
CITY OF ORONO
P.O.BOX 66
CRYSTAL BAY, MINNESOTA 55323
/ (612) 473-7357
I
Owner / e C
11
Contractor i/(�/✓LU��
City License No. �2 0 a 7
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE
Inside Plumbing (#fixtures_)
Water Meter (Size—)
Meter N
Remote
NEW ❑ ADDITION
Fee S
Fee S
Municipal Water Connection Fee S
❑Copper n
Municipal Sewer Connection Fee S
❑ PVC ❑ Cast 0-
MWCC SAC Charge
On Site Septic System
ACKNOWLEDGEMENT
CITY PERMIT NO. 8025
Date U /' -- S'-�
� / L
Address A� 90
Address n y -
State License No.
❑ REPAIR
ater Well
Mechanical Equipment
g /Lifting Buildings
nd Alteration (Excavation,
Grading, Filling, etc.)
Fire
Sprinkler System (Fire)
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S ___ ther: Fee S
Fee S After -the -fact Investigation Fee S
The undersigned hereby acknowledges receipt of this limited
permit. Including acceptance of all soeeial information.
terms, eoadftions at regvinments written above. The
undersigned understands and sanft under penalty of law
that this permit is strtetiy limiled In scope to the work.
activity or improvement specified: that this peewit does
not pant any authority to do work or activities reQulelnh
=paste permit approval&. and that this permit does not
pant authority to violate say provision of any City
ordinance or State law, rule or regulation. Ali work @ball be
done in strict compliance with all City ordinances, building
codes and/or health department regulations, and shell be
sableet to Inspection, approval or rsMction by the City.
Whenever so ordered. the undersigned agrees to correct
any work found to be In violation of the conditions of
this permit.
l •atl�re of Applit!t
/ �.
TOTAL
State Surcharge: Fee S Sy
Total Amount Paid to City Fee S "�O' SU
This permit is not valid until the proper fee is paid and
it is approved by an authorized City Official.
Signatuje of City
Code: White - File Copy Canary -Inspector's Copy Pink -Finance Copy Gold -Applicant's Receipt