HomeMy WebLinkAbout1987-9067 (SAC) GENERAL PERMIT CITY PERMIT �� s o s 7
CITY OF ORONO
P.O.BOX 66 Date �
CRYSTAL BAY,MINNFSOTA 55323
(61 73-7357
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Owner a Address � `�--— - � �'�--- " —- .
Contractor Address
City License No. City
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: O NEW O ADDITION ❑ REPAIR ❑ REMODEL
Inside Plumbing(#fixtwes ) Fee $ Water Well Fee $
Water Meter(Size ) Fee $ Mechanical Equipment Fee $
Meter# Fireplace/Wood Stove Fee $
Remote# Moving/Lifaing Bu�dings Fee $
Municipal Water Connection Fee $ Iand Altera.tion(Excavation,
❑ Copper ❑ Grading,Fi7ling,etc.) Fee $
Design Review Fee $
Municipal Sewer Connection Fee $ Fire Fee $
❑ PVC ❑ Ca.st �
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 $
The undersigned hereby acknowledges receipt of this limited permit, ���'
includi� acxephance of all special infortnation, temis, condidons or Total Amount Paid to City Fe2 $ gl��.��
requirements written above. The undersigned unde�lands and agrees
under penalty of law that this pemtit is strictly limited in scope to the work,
activity or improvement specified;that this pemtit does not giant any
authority todo work oractivities requiring separate permitapprovals;and
that this pertnit dces notgrant authority to violate any provision of any City
ordimnce or State law,nile or regula6on All work shall be done in strict �permit is not valid unt�the proper fee is paid and it is approved
compliance with atl City ordinances, bw7ding codes and/or health by an authorized Ciry O�cial.
department regulations,and shall be subje�t to inspa;tion,approval or
rejecdon by the Ciry.Whenever so ordered,the undersigned agrees to
correct any work found to be in vialation of the conditions of this permit.
Signature of Applicant
Si ture f City O�cial
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Code: White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt