HomeMy WebLinkAbout1986-8604 (SAC) GENERAL PERMIT CTTY PERMTT No s s o�
CITY OF ORONO
P.O.BOX 66 Date �� � r /� �
�
CRYSTAL BAY,MINNESOTA 55323
612)473-7357
Owner ' � � Address �� � ��
Contractor Address
City License No. City �
REMARKS AND SPECIAL CONDITIONS .
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDTITON ❑ REPAIR ❑ REMODEL
Inside Plumbing(#fixtures ) Fee $ Water Well Fee $
Water Meter(Size ) Fee $ Mecha.nical Equipment Fee $
Meter# Fireplace/Wood Stove Fee $
Remote# Moving/Lifting Bu�dings Fee $
Municipal Water Connection Fee $ Iand Alteration(F�ccavation,
❑ Copper ❑ Grading,F�71ing,etc.) Fee $
Design Review Fee $
Municipa�Sewer Connection F� $ Fire Fee $
❑ PVC ❑ Cast ❑ �
MWCC SAC Charge Fee $ � Sprinkler System(Fire) Fee $
Other. Fee $
On Site Spetic System Fee $
After-the-fact Investigation Fee $
,
ACKNOWLEDGEMENT TOTAL
, State Surcharge: Fee $
'fhe undersigned hereby acknowl� receipt of this limited pemut, ��1
1
including accephance of all special information, ternu, conditions or Total Amount Paid to City FP� $ � �
, requirements written above. The undersigned undersmnds and agrees
under penalty of law that this permit is strictly limited in scope to the work,
activity or improvement specified;that this permit dces not grant any
authority to do work or activities requiring separate permit approvals;and
that this permit dces notgrant authority to violate any provision of any Ciry
ordimnce or State law,nile or regulaaon.All work shall be done in strict '�permit is not valid until the proper fee is paid and it is approved
compliance with all City ordinanc�s, bmlding codes and/or health b an authorized Ci ��Cl�.
department reguladons,and shall be subject to inspeclion,approval or y �'
rejection by the Ciry.Whenever so ordered,the undersigned agrees to
correct any work found to be in vialadon of the conditions of this permit.
'e of Applicant
Signature of City Off '
a
Code: White—File Copy Canary—lnspector's Copy Pink—Finance Copy Gold—Applicant's Receipt