HomeMy WebLinkAbout1986-8375 - masonery fireplace GENERAL PERMIT CITYPERMITNO. 83'��
CITY OF ORONO
s �
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner ��� �� ���� ' Address ��(.��� ��--�� �� ��•
Contractor ress
City License No. , State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: � NEW ❑ ADDITION ❑ REPAIR
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 $
n Grading, Filling, etc.)
❑Copper
Municipal Sewer Connection Fee $ _ Fire Fee $
❑ PVC ❑Cast Q 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
pexmit, including acceptance of all special information, �
terms, conditions or requirements written above. The State Surcharge: Fee .p /�
undersigned understands and agrees under penalty of law
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 $ J�
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 �aior health department regulations, �,a sh8u be This permit is not valid until the proper fee is paid and
subiect to inspection, approval 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 Offici 1
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Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt