HomeMy WebLinkAbout1985-8280 (SAC) GENERAL PERMIT CITYPERMITNO. szgo
CITY OF ORONO Date �a� � �
r.o.aox 66
CRYSTAL BAY,MINNESOTA 55323
(612)473-7357
Owner A�� ��h Address� � � �� �t T •
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 $ Mechanica.l Equipment Fee $
Meter#
Remote,# Moving/Lifting Buildings Fee $
Municipal Water Connection Fee $
La.nd Alteration (Excavation, Fee $
❑Copper ❑ Grading, Filling, etc.)
Municipal Sewer Connection Fee $
Fire Fee $
❑ PVC ❑Cast n Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $��� Other: Fee $
L
On Site Septic System Fee $ After-the-fact Investigation Fee $
,
ACKNOWLEDGEMENT TOTAL
The underslgned hereby acknowledgea receipt of this limited
permit, includ9ng acceptence of all spedal informatlon,
terms, condittons or xequiremenis wiitten above. The State Surchar e• Fee $
undersigned undezatands and agrees under penaltq of law g •
that this Permit is atrictlY limited in ecope to the work, �jq
, a
activity or improvement specifled; that this Permit doea ��CXJ
not grant anY authorlty to do wark or activitiea requiring Total Amount Paid to City Fee $
sepazate permit aPprovels; and that thie permit doea not
grant authoxitY to vlolate any provieton of any CitY
ordinance or State law,rule or regulation.All work ahell be
doae iln strlet compliance with ali CitY ord�laancea,building
codes andJor health depertmeat regulatione, end ahaII be 'This permit is not valid until the proper fee is paid and
sub�ect to inapect3oa, approval or xejection by the City, it is approved by an authorized City Official.
Whenever so ordered, the undex�gned egreea to correct
any work found to be in vlolat[oa of the conditlona oP
tk�s permit.
Signature of Applicant Signa re of City fficial
`-��Y1�- � �J
Code:White—F�le Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt