HomeMy WebLinkAbout1983-7011 - general permit GENERAL PERMIT CITYPERMITNO. __—�oii �
CITY OF ORONO ,
P.O.BOX 66 Date_�� , �
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Owner �/� Adeir�:ss � ��� ��L1C"� U-t- C9ee
Contractor ��G�� �� Address
City License No. State License No.
RF;MARKS AND SPECIAL CONDITIONS
I'ERMIT TYPE AND FEE: �NEW ❑ ADDITION ❑ REPAIR
lnside Plumbing � # fixtures ) Fee $ On Site Septic System F�e �
��
Water Meter (Size,� Fee $�L— Water Well Fee $
Meter # 3e� 10 32�a
' Mechanical Equipment Fee $
Re����te# �a � �.-�
a`� Moving/Lifting Buildings Fee $
Municipa Water Connection Fee $�� s
Copper ❑ Land Alteration (Excavation, Fee �
Grading, Filling, etc.)
Mttnicipal Sewer Connection Fee $
❑ PVC ❑ Cast n Other: Fee $
MJVCC SAC Charge Fee $ After-the-fact Investigation Fee $
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ACKNOWLEDGEMENT TOTAL ��•—
The undersigned hereby acknowledges receipt of this limited
permit, including acceptance of all special information, �� �
ternts, conditions or requirements written above, The
undersigned understands and agrees under penaltY of law State SUr(;11dI�Te: Fet' $
that this permit is strictly limited in scope to the work, �
activity or irnprovement specified; that this permit does
not grant any authority to do work or activities requiring Total Amount Paid to City FeC � �—
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 T�11S iJeIIl71t IS IlOt V311C1 U11t11 tlle pI'Oj�eC fee IS �31C� 8[1C�
subiect to inspection, approval or reiection by the c�cv. 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.
Sigriature f Applicant Signature of City ffici
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Code:White—Pile Copy Canary—Inspectc�r's Copy Pink—I inance Copy Gold—Applicant's Receipt
CITY OF ORONO CALLED-IN
—�
INSPECTION NOTICE /1 .�r
SCHEDULED
PERMIT NO. � � COMPLEC
ADDRESS /
OWNER �� CONTR
❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING .,���M��ECHANICAL � EXCAV./GRADING/FILLING
� ❑ INSULATION �wATER HOOKUP ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. �p 1VIETER SET/TURN ON ❑ LICENSING
W ❑ FINAL ❑ SEWER HOOKUP ❑ COMPLAINT
� ❑ PROGRESS ❑ SEPTIC INSTAL�. ❑ FOLLOW-UP
� ❑ DEMOL. ❑ SEPTIC MAINT.
O O FIREPREV. ❑ WELLTESTPUMP �
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W p'WORK SATISFACTORY: PROCEED ❑PHOTO TAKEN
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Q ❑ CORRECT WORK& PROCEED
V ❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WI�L RETURN.
❑ STOP ORDER POSTED. CAL� INSPECTOR.
❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS.
Please call for the next inspection 24 hours in advance.
Owner/Contr. site
I nspector / �473�7357
White Copy/Inspector's File Gold Copy/Site Notice