HomeMy WebLinkAbout1984-7703 - general permit GENERAL PERMIT �ITYPERMITNO. ��03
CITY OF ORONO
P.O.BOX 66 Date ` � �
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Owner ----� DN�� � �/NiS Address ���� C��� �7` 1�L�
Contractor V� 1 '�th-1�-12- �Iz-��' • Address S��-j^1� �A*�ic
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
��� �L-K-�.r��-�r- �o��3 � -�l S`-�'� ("N�v�2 �e�Nr��t� ,n� :�S�1
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) Fee $ Water Well Fee $
�c
Water Meter(Size�) Fee � —�._. Mechanical Equipment Fee $
Meter# J �e''�' �
Remote# ' �C Moving /Lifting Buildings Fee $
Municipal Water Connection Fee $ Land Alteration (Exeavation, Fee $
� 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 xequirements written above. The ,,,_
undersigned understands and agrees under penalty of law State Surcharge: Fee $
that this permit is stricUy limited in scope to the work, �Q
activity or improvement specified; that this permit does Q �
not grant any authority to do work or activities requiring Total Amount Paid to City Fee .p �
separate permit approvals; and that this Permit does not
grant authority to violate any provision of any City
ordinance oz State law,rule or regulation.All work shall be
done in strict compliance with all City ordinances,building
codes and/or health department regulations, end shall be This permit is not valid until the proper fee is paid and
subiect to inspection, approvai or reiection by the c�tY. 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
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Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt