HomeMy WebLinkAbout1986-8466 - general permit GENERAL PERMIT CITYPERMITNO. g466 '
CITY OF ORONO / Q�/
P.O.BOX 66
Date_ �7 �� ��) ((�
CRYSTAL BAY, MINNESOTA 55323
(612)473-7357
Owner �-2-Cl�t J !��/�-e-�' Address •
Contractor Address
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑ REPAIR ,
�side Plumbing (#fixtures_) Fee $ Water Well Fee $
ater Meter (Size_) Fee $ Mechanical Equipment Fee $
Meter#
Remote� Moving /Lifting Buildings Fee $
unicipal Water Connection Fee $ Land Alteration (Excavation, Fee $
n Grading, Filling, etc.)
❑Copper
unicipal Sewer Connection Fee $ _ _
Fire Fee $
❑ PVC ❑Cast n � Sprinkler System (Fire) Fee $
+VCC SAC Charge Fee $ � ther: Fee $
Site Septic System Fee $ After-the-fact Investigation Fee $
.CKNOWLEDGEMENT 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 improvement 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 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 This permit is not valid until the proper fee is paid and
subiect to insnection, apProval or reiection by the estY. it is approved by an authorized City Official.
Whenever so ordered, the undersigned agrees to conect
any work found to be in violation of the conditions of
this permit.
re of Applicant Signature f City Offici
��'C�--�?�,- Cc.— � /`,� '�-- ,
Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt
DATE TIME
�TY OF ORONO CALLED iN —__ _ _
INSPECTION NOTICE SCHEDULED � ��.`-y_�„'_ - --���/
PERMIT NO. COMPLETED �_�� �� � ��r'�,
_ �
ADDRESS �C� C ,
OWNER CONTR.
TELEPHONE NO. �
� FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING ❑ PLUMBING FINAL ❑ EXCAV./GRADING/FILLING
� ❑ INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. ❑ WATER HOOKUP � LICENSING
� ❑ FINAL ❑ METER SET/TURN ON ❑ COMPLAINT
� ❑ PROGRESS �SEWER HOOKUP ❑ FOLLOW-UP
� ❑ DEMOL. SEPTIC INSTALL. ❑ SEPTIC FINAL
Q ❑ FIRE PREV. ❑ SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER
� ❑ WELL TEST PUMP ❑ _ _
Q COMMENTS:
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QW �WORK SATISFACTORY:PROCEED � PHOTO TAKEN
❑ CORRECT WORK&PROCEED
C_1 ❑ CORRECT WORK.CALL FOR REINSPECTION BEFORE COVERING
`7 CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN.
❑ STOP ORDER POSTED.CALL INSPECTOR.
7 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. on site
I nspector_ 413-7357
White Copy/Inspector's File Gold Copy/Site Notice