HomeMy WebLinkAbout1986-8409 (Sewer Connection) GENERAL PERMIT CITYPERMITNO. 8409 �
CITY OF ORONO �. ��
P.O.BOX 66 Date
CRYSTAL BAY,MINNESOTA 55323
(612)473-7357
Owner � � � Address /�l� �� �
r— �
Contractor � ss
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City License No. � State License No.
REMARKS AND SPECIAL CONDITIONS _
� � 3/ �S" ��
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 $
I--� Grading, Filling, etc.)
❑Copper
Municipal Sewer Connection Fee $
Fire Fee $
❑ PVC �ast n �� Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ � ' Other: Fee $
On Site Septic System Fee $ After-the-fact Investigation Fee $
ACKNOWLEDGEMENT TOTAL
The undersi�ed hexeby acknowledgea receipt of this limited
permit, including acceptance of ell apedal in4ormatton, �
terma, conditions or xequiremeats wsltten above. The State Surchar e• Fee $ ` `J
undersigned undexatands and agraes uader penelty of law g • �
that this pemilt is atrlctly llmited in scope to the work, ��
activltY or improvement apecified; that this permit does
n�c �t �y aur�o�� co ao W�k or a����ce8 �q,�� Total Amount Paid to City Fee $ `
sepazate permit approvals; and that thia pera►it does not
grant authoritY to violate an9 Provieion of any City
ordineace or State law,rule or regiilatlon.AII work shall be
done in atrlct complience with all CitY ordinencea,buildin�
codes and/or health departmeat regulatlons. aad ahell be 'This permit is not valid until the proper fee is paid and
subiect to inapection, approval br rejectlon by the City. it is approved by an authorized City Official.
Whenever eo ordered, the undersigned agreea to cottect
aay work found to be in violatioa of the conditions oP
this permit.
Signature Applicant Signatu of City Official
Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt