HomeMy WebLinkAbout1987-05-06 Permit. Septic System #8995; *■
GENERAL PERMn CITY PERMIT N9 8995
CITY OF ORONO
P.O.BOX66
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Date 7
\Owner ____
0uicku!6.<^£xc ■
Chy license No,_________________________
Address
Address
City _£oc /
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE:
Inside Plumbing (^fixtures_
Witter Meter (Size___)
Meter#__________
-)
V NEW
Fee $
□ REPAIR
Fee $
Remote #
Municipal Water Connection
□ Copper □ ___
Fee $
Municipal Sewer Connection
□ PVC □ Ciist □
MWCCSACdiarge
On Site Spetic System
Fee $
□ ADDITION
Water Well
Mechanical Equipment
Fireptace/Wcxxl Stove
Moving/Liliting Buildings
Land Alteration (Excavation,
Grading, Filling, etc.)
Design Review
Fire_________________
Fee S
Fee $ 25.-
□ REMODEL
Fee $ _
Fee S _
Fee $ —
Fee $ _
Sprinkler System (Fire)
Other ___________
After-the-fact Investigation
Fee $
Fee $
Fee $
Fee S
Fee $
Fee $1
ACKNOWLEDGEMENT
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The umlcTMgned horby acknowledpsr receipt of this limited permit,
inciudiiy acceptance of alt «{Kcial information, terms, conditions or
ie«(uiremcnis written ahne. The undersigned understands and agrees
under penalty of law that this permit is strictly limited in scope tt> the work,
actisity or improwment specined that this |vrmit does not grant any
authority todti work or activities rei|uiring separate permit approsaK; anil
that this permit docs not grant authority to violate any pnwision of any City
ordnance or State bw. rukr or nrgubtion AH work shall he done in strict
compliancv with alt City oidinancev building codes and/or health
department regubtions. and shall he subject to inspection, approval or
rejeclion bv the City Whenever s»* ordered, the undersigned agavs to
correct any work found to he in viobtion of the conditions of this permit
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Applimht
TOTAL
State Surcharge:
Total Amount ftid to City
Fee $
Fees ,7^-^^.,
*
This permit is not valid until the proper fee is paid and it is approved
by an authorized City Official.
Signa^ of Citv Oflicial /OL J AJa<'
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Cede WNlc- Rlc Copy Canary— Inspccinr’s Copy Pink- Finanev Copy Gold—Applkam's Reedpi
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