HomeMy WebLinkAbout1986-8537 (Sewer Connection) . GEN�RAL PERMIT CITYPERMITNO. 853'7 �
CITY OF ORONO _�� _
P.O.BOX 66 Date
CRYSTAL BAY,MINNESOTA 55323
(612)473-7357
Owner Address l ��� U�'d ��J7 �� '
Contractor n� Address���CC1�� d ,�� a� I
City License No. � � State License No.
REMARKS AND SPECIAL CONDITIONS
��C � �� 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 $
❑Copper ❑ Grading,Filling, etc.) �
ire Fee $
Municipal Sewer Connection Fee $ I
�PVC ❑Cast n Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other: Fee $
On Site Septic System Fee $ After-the-fact Investigation Fee $ '�
,
ACKNOWLEDGEMENT TOTAL
The undexsigned hereby acknowledgea receipt of thie limited
permit, including acceptence of ell epedal iaPozmation, } �
terms, conditiona or xequirements wsitten above. The State Surcharge: Fee $
uadersigned underatands and agees uader penelty oY law
that this pemiit is strictly lixnited ia scope to the work, '
activitq or 9mprovement speci�ed: that t�is permit doea P�
not grant anY authorlty to do wark or activittes requ9ring Total Amount Paid to City Fee ��`
separate permit approvals; aad that this pemiit does aot �
graat authority to violete any provis[on of any City �i
ordinance or State law,rule or regulation.All work ahall be
done ia strlct complisnce with aII CitY ordiaancae,bwllding
codes and/or health department reGulatlons, end ehall be 'This permit is not valid until the proper fee is paid' fl11Ci
sub9ect to inaPectioa, apHroval or reiection by the City, it is approved by an authorized City Official. '
Whenever eo ordered, the undersigned egreea to correct
any work found to be in vtolat3on of the conditlona oP
this Permit.
Signatur of Applicant Signa of City Official
� �'
Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Go d—AppHcant's Receipt