HomeMy WebLinkAbout1985-7788 - install natural gas piping GENERAL PERMIT CITYPERMITNO. ��HH
CITY OF ORONO
P.O.EOX 66 Date '� � �
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Owner �. L—��?� f�����'�`� Address ��� ,,, ��c.k'7�� /��7�� /��
Contractor .�� '�' ��• (J`�� ���-���'�_ Address 7 ��% �)��/. ��f1 c� �C:��`i'�� /q-, l .
City License No.�,� �/ /'1 ��' State License No.
REMARKS AND SPECIAL CONDITIONS
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F�iC �� ��� . P �`'��`1-�'
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR
Inside Plumbing (#fixtures_) Fee $ Water Well Fee $
Water Meter (Size_) Fee � Mechanical Equipment Fee $���`Z/ LJi�,
Meter#
Remote�$ 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 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 State Surchar e: Fee $_ � �
undersigned understands and agrees under penalty of law g
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 F00 $-�
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, snd shall be This permit is not valid until the proper fee is paid and
subiect to inspection, approval or reiection by the City. lt 1S 3 roved b an authorized Cit Official.
Whenever so ordered, the undersigned agrees to conect pp Y Y
any work found to be in violation of the conditions of
this permit.
Sign re of 'can Signatur of C�ty Official
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Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt