HomeMy WebLinkAbout1985-8266 (SAC) GENERAL PERMIT CITYPERMITNO. - s2ss �
CITY OF ORONO Date — �c� � ��
r.o.aox 66
CRYSTAL BAY,MINNESOTA 55323
(612)473-7357
Owner � - � Address_ ���� ��(� ��r
.� -
Contractor Address
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: �' NEW ❑ ADDITION ❑REPAIR
Inside Plumbing (#fixtures_) Fee $ Water Well Fee $
Water Meter(Size—) Fee $ Mechanical Equipment Fee $
Meter#
Remote# Moving/Lifting Buildings Fee $
Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $
❑Copper � Grading,Filling, etc.)
Municipal Sewer Connection Fee $
Fire Fee $
❑ PVC ❑Cast n Q� Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ �° Other: Fee $
On Site Septic System Fee $ After-the-fact Investigation Fee $
ACKNOWLEDGEMINT TOTAL
The uadersigned hereby ac3mowledges receipt of this limited
permit, including acceptance of all special infoxmation,
terms, conditions or requirements written above. The
undersi�ned understands and agrees under penalty of law State Surcharge: Fee $
that this pemiit is atiictlY limited in scope to the wark,
activity or imProvement specified; that thia permit doea ��•�
not graat anY authorlty to do wask or activitiea requlztng Total Amount Paid to City Fee $
separate permit approvals; and that this peanit doea not �
�ant authorltY to violate anY Psoviaion of any City
ordinance or State law,rule or regulation.AII work aheII be
done in sd3et complience with all CitY ordinances,bwllding
�oaee �aio: he�r� aea�e�t re��o�, �a �an � This permit is not valid until the proper fee is paid and
sub3ect to inaHection, apBroval or xeiectlon bq the City. it is approved by an authorized City Official.
Whanever so ardered, the underai�ed a�eea to correct
any work found to be in violation of the condittons oP
this permit.
Signature of Applicant Signature of City Official
, �,s���-.�/ �
Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt