HomeMy WebLinkAbout1986-8802 (SAC) GENERAL PERMIT ��P�� N� s s o z
CITY OF ORONO
P.O.BOX 66 Date /
CRYSTAL BAY,MIlVNESOTA 55323
(612)47 -7357
Owner f'1 �O Address� �/���C�l�' � `
Contractor (/�,���il!'I'l PP^ p�� � -�/��
City License No. � Ciry
REMARKS AND SPECIAL CONDTITONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR ❑ REMODEL
Inside Plumbing(#fixtures ) Fee $ Water Well Fee $
Water Meter(Size ) Fee $ Mechanical Equipment Fee $
Meter# Fireplace/Wood Stove Fee $
Remote# Moving/Iafting Bu�dings Fee $
Municipal,Water Conn�tion Fee $ Land Alteration(Excava.tion,
❑ Copper ❑ Grading,F�ling,etc.) Fee $
Municipal Sewer Connection Fee $ �� •� Design Review Fee $
C�PVC ❑ Cast ❑ Fire Fee $
MWCC SAC Charge Fee $ .5.� Sprinkler System(Fire) Fe� $
Other. Fee $
On Site Spetic System Fee $ �._�e-fact Investigation Fee $
ACKNOWLEDGEMENT TOTAL
State Surcharge: Fee $ � �
The undersigned hereby acknowle�reteipt of this limited permit, �v���'�
includ'uig acceptance of all spectial information, terms, conditions or TO�E�IIlOUIIt�d1C�t0 C1Ty FP.e $
requirements written above.The undersigned understands and agrees
under penalty of law that this permit is shictly limited in scope to the work,
activity or improvement specified;that this permit doe.s not giant any
authority to do work or activiUes requiring sepa►a�permit approvaLs;and
that this permit dces notgantauthority w violate any provision of any Ciry
ordinance or Smte law,rule or regulation.All work shall be done in strict �pe�t is not valid unt�7 the proper fee is paid and it is approved
compliance with all City ottlinances, bwlding codes and/or health
department reguladons,and stiall be subject to insp�on,approval or by an authorized Ciry Official.
� rejection by the Ciry.Whenever so ordered,the urttiersigned agre�.c to
�correct any work found to be in viala�rin of the condilionc of this permit
�e of Applicant
� , Signa e of City Offcia.
,.z���!'`-��/' Gv/�.� �
White—Fle Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanPs Rec:eipt