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HomeMy WebLinkAbout1986-8452 (water meter) GENERAL PERMIT CITYPERMITNO. g452 CITY OF ORON4 � _ �._ p P.O.BOX 66 Date � C)� CRYSTAL BAY, MINNESOTA 55323 (612) 473-7357 Owner Address �� � ��l�C�j �p � -� Contractor Address City License No. State License No. REMARKS AND SPECIAL CONDITIONS /.��c��- ��x�.�- ���/� 7�7CP(� PERMIT TYPE AND FEE: �iEW ❑ ADDITION ❑ REPAIR Inside Plumbing (#fixtures_) Fee $ Water We11 Fee $ Water Meter(Size� 3�� Q���� Fee $ / 5` �� Mechanical Equipment Fee $ Meter# Remote�$ � ` 5 Moving /Lifting Buildings Fee $ Municipal Water Connection Fee $—��- Land Alteration (Excavation, Fee $ n Grading, Filling, etc.) ❑Copper Municipal Sewer Connection Fee $ _ _ Fire Fee $ ❑ 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 undersigned hereby acknowledges receipt of this limited permit, including acceptance of all special information, terms, conditions or requirements written above. The undersigned understands and agrees 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 ^ �'C,� grant authority to violate any provision of any City �-Jf� ordinance or State law,rule or xegulation. All work shall be done in strict compliance with all City ordinances, building codes �aior 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. lt 1S 3 roved b an authorized Cit Official. Whenever so ordered, the undersigned agrees to correct pp Y Y any work found to be in violation of the conditions of this permit. Signat e of Applicant Signature of City Official . � � '�/�G `' Code:White—FIIe Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanYs Receipt