HomeMy WebLinkAbout1986-8325 - septic install GENERAL PERMIT CITYPERMITNO. g325
CITY OF ORONO �, _ � _ , _
P.O.BOX 66 Date G
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
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Owner � C ` � Address �' � `C..�
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Contractor � ��ddress � �• � � � ��'l
City License No. �� � State License No.
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE: NEW ❑ ADDITION ❑ REPAIR
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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 n Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other: Fee $
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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 a�ees under penalty of law State Surcharge: Fee $
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 Fee $ �
sepazate permit approvals; and that this permit does not
grant authOriSy to violate any pYOvisiOn 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
subiect to inspection, approval or reiection by the c�cy. 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 perxnit.
Signatu of Ap .licant Signature of City Official
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Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanYs Receipt
'/// DATE TIME
�// CITY OF ORONO CALLED IN
v INSPECTION NOTICE SCHEDULED �'��"�� 3�aa .
PERMIT NO. MP��rE� �'2� "� --�i- ��
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ADDRESS � ,r � �.�i a-3Z Ri�c �5�.•vqlv�
OWNER �E C�AG�'�S CONTR.
TELEPHONE NO. L��s
❑ FOOTING ❑ PLUMBING RI NSPECTION
� FRAMING ❑ PLUMBING FINAL ❑ EXCAV./ /FILLING
� O INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. ❑ WATER HOOKUP ❑ LICENSING
ll� ❑ FINAL O METER SET/TURN ON 0 COMPLAINT
� ❑ PROGRESS t7 SEWER HOOKUP ❑ FOLLOW-UP
� ❑ DEMOL. .�SEPTIC INSTALL. O SEPTIC FINAL
Q � FIRE PREV. C SEPTIC MAINT. O FIREPlACE1W000 BURNER
� ❑ WELL TEST PUMP ❑
Q COMMENTS:
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'-J CORRECT UNSAFE CC�491dlUN W�THIN��I�ECTOR WI _ N.
❑ STOP ORDE LINSPECTO `�-
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. �
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call for the next inspection 24 hc�i`�"in d�ance.
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Owner/Contr. on site � �- � �—
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Inspecto ���'` 473-7357
White/�nspector's File Canary/Site Notice
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Eau Claire,WI 54701 � Bloomington, MN 55431
2216 Birch Street 9800 South James Circle
(715)832•0422 (612)881•4780
Rochester,MN 55901 � Fargo, N. D.58102
1711 3rd Avenue S.E. 30 South 27th Street
(507)288-4088 (701)235-0526
CLUTCH 6 TRANSMISSION SERVICE,INC.
St. Paul, MN 55113
2785 Long Lake Road
(612)636-4311