HomeMy WebLinkAbout1986-8285 - plan review only GENERA
L PERMIT CITYPERMITNO. 82g5
CITY OF ORONO (�
P.O.BOX 66 Date � `— �� (� �
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner ��1��. ��_ �1��T b�� Address 1 �,��' 1(ti = , ��–� ��1� _i�
Contractor Address
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
t��.--�A�t�l �'_ � 1� '_ �„1
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 $
� Grading, Filling, etc.)
❑Copper
Municipal Sewer Connection Fee $ _
Fire Fee $
❑ PVC ❑Cast n Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other: �"L�� ��G����,JU Fee $ 1 ��S
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 r-----•
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 itnprovement specified; that this permit does �7 �I
not grant anv authoritv to do work or activities rectuiring Total Amount Paid to City Fe0 $ �
sepazate permit approvals; and that this permit does not
�ant 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
�oaes �aior health department regulations, �a sh8u »e This permit is not valid until the proper fee is paid and
�n;e�t co inspection, approval or rejection by r�e 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 plicant Signature f Ci ici
/' �� -
Code:White—FIle Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt