HomeMy WebLinkAbout1985-8121 (void permit)] GENERAL PERMIT CITYPERMITNO. 512� �
CITY OF ORONO ��f � � 5
P.O.BOX 66 Date _�,__�__
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner L�� ��I�� Address ��W � �U�� � � _
Contractor LLl�l� �� � C� C��1 Address ��� �'
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
_ C
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION �,I R PAIR
Inside Plumbing (#fixtures_) Fee $ ter Well Fee $
Water Meter (Size_) Fee $ Me hanical Equ ment Fee $
Meter# _
Remote�# Movi /Lifting B ildings Fee $
Land Alteration (E ation, Fee $
Municipal Water Connection Fee $ - Grading, Filli g, etc.)
❑Copper
Municipal Sewer Connection Fe $ _ Fire Fee $
❑ PVC ❑Cast Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other: Fee $
On Site Septic System Fee After-the-fact Investigation Fee $
ACKNOWLEDGE NT TOTAL
The undersigned he by acknowled s receipt of this limited
permit, including a eptance of special information, /_-Q
terxns, conditions or requiremen written above. The J
undersigned understan and agree under penalty of law State Surcharge: Fee $
that this permit is strictl limited in scope to the work,
activity or unprovement sp ified; that this permit does
not grant any authority to do k or activities requiring Total Amount Paid to City Fee �
sepazate permit approvals; and that this Permit does not
grant authority to violate any provision of any City
ordinance or State law,rule or regulation. All work shall be
done in strict compliance with all City ordinances,building
codes and/or health department regulations, and shall be This permit is not valid until the proper fee is paid and
subiect to inspection, approval or rejection by the c�cy. it is approved by an authorized City Official.
Whenever so ordered, the undersigned agrees to correct
any work found to be in violation of the conditions of
this permit.
Signature of Applicant Signature of City Official
Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt