HomeMy WebLinkAbout1984-7713 (plumg) GENERAL PERMIT CITYPERMITNO. ��13
CITY OF ORONO ,�-
r.O.EOX 66 Date �
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Owner � -��:�L-��� Address ��Z��, �A��( S 1 1��y �_ ��
Contractor [raC�41C_,�Lz� A-y Address �c.'x'rL�U/"��
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION �ZEPAIR
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 $
� Grading, Filling, etc.)
❑Copper
Municipal Sewer Connection Fee $ _
Fire Fee $
❑ PVC ❑Cast Q Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other: Fee $
—crts
On Site Septic System Fee $ �=� After-the-fact Investigation Fee $
ACKNOWLEDGEMENT TOTAL
The undersigned hexeby acknowledges receipt of this limited
permit, including acceptance of all special information,
terms, conditions or requirements written above. The �
undersgned understands and a�ees under penalty of law State Surcharge: Fee �
that this permit is strictly limited in scope to the work, ,��
activitY or improvement specified; that this permit does {'"— �—
not grant any authority to do work or activities requiring Total Amount Paid to City Fee $ �
separate 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
subject to inspection, approval or reiection by the City.
Whenever so ordered, the undersigned agrees to correct it is approved by an authorized City Official.
any work found to be in violation of the conditions of
this permit.
Sig tur of Ap ' Signature of City Official
✓ -�}' � r
Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt
T£���� TIME
CITY OF ORONO cA��E�-iN /
INSPECTION NOTICE scHE�u�Eo ���� � G
PERMIT NO. connP�ErEo ��� �1 -`�}
ADDRESS -� �.-��� S� ��� ��� c� .
OWNER �G�-V"fI�� CONTR. � -1.�'�
TELEPHONE NO.
❑ FOOTING �PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING ❑ MECHANICAL ❑ EXCAV./GRADING/FILLING
� ❑ INSULATION ❑ WATER HOOKUP ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. ❑ METER SET/TURN ON ❑ LICENSING
ty� ❑ FINAL ❑ SEWER HOOKUP ❑ COMPLAINT
� � PROGRESS ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
� ❑ DEMOL. ❑ SEPTIC MAINT. ❑ SEPTIC FINAL
Q ❑ FIRE PREV. ❑ WELL TEST PUMP ❑ FIREP�ACE/WOOD BURNER
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W WORK SATISFACTORY: PROCEED ❑PHOTO TAKEN
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Q/ p'CORRECT WORK& PROCEED
V ❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
❑CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
❑STOP ORDER POSTED. CALL INSPECTOR.
❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. on site
I nspector� I � � �'3-�- Q73-7357
White Copy/Inspector's Ffle Gold Copy/Site Notice