HomeMy WebLinkAbout1985-8274 (SAC) CITY PERMIT NO. g 2'�� �
GENERAL PERMIT
CITY OF ORONO I�_� I_ �
P.O.BOX 66 Date
CRYSTAL BAY,MINNESOTA 55323
(612)473-7357
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Owner ��'�'���' e'(�� Address L �L. �7� .
Contractor Address
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑REPAIR
Inside Plumbing(#�xtures_) 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 �� Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ � Other: Fee $
On Si�e Septic System Fee $ After-the-fact Investigation Fee $
ACKNOWLEDGEMENT TOTAL
The undersigned hezeby acknowledges receipt of this llmited
permit, including acceptance oY all spedel informatlon.
terma, conditlons or xequfrements wzltten above. The
undersigned understands end agxees under penelty of law State Surcharge: Fee $
that thia Permit is strlctly limitsd in ecope to the wosk,
activitY or improvement sAecifled; that this permit does �
not �ant az►Y authority to do wark or activitiea requiring Total Amount Paid to City Fee $
seperate permit apProvals; aad that this pe�it doea not -
grant authorlty to violate aay provieion oY any City
ordinance ox State law,rule os xegulation.AIl work ahall be
done in ah3et compltance with all CitY ordinancea,building
codes and/or health department regulatlona, and shall be This permit is not valid until the prope*
sub9ect to insPection, approval bz reiection by the City. it is approved by an authorized City(`
Whenever so ordered, the undetatgned agrees to correct
any work found to be in vlolation of the conditions of
this Permi�
Signature of Applicant Signature f City Offici
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Code:White—File Copy Canary—Inspector's Copy Pink—Finence Copy Gold—Applicant's A