HomeMy WebLinkAbout1985-7858 - general permit GENERAL PERMIT CITYPERMITNO. �858
CITY OF ORONO 3_� �_ ,� �---
P.O.BOX 66 Date
CRYS AL BAY, MINNESOTA 55323
(612)47 - 357
�
Owner -��Y�-' Address /"�d /e `e
� (,j_, �
Contractor `Q.� Address �� I I Ul9 1� ��Q ��' (��n-
City License No. �� �� State License No.
REMAR AND SPECIAL CONDITIONS
�� . i�..��� �?-�� ���e � ��.a-��.
PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION EPAIR
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 � 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, �O
terms, conditions ox requirements written above. The
undersigned understands and a�ees under penalty of law State Surcharge: Fee $ '
that this permit is stricUy limited in scope to the work, _ _^
activity or irnprovement specified; that this permit does ��`j
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
�oaes and/or health department regulations, �a �eu ne 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 conect
any work found to be in violation of the conditions of
this permit.
Signatur �rof A�plic nt Signat ;�of City Official /
� � � Q�
l'�f�, ,,�`.�� // . `�' � � _"_�--- I ,�0 �-1� � —
..f���
�
Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanYs Receipt
DATE TIME
CITY OF ORONO CALLED-IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. COMPLETED �1��5�_ I•'�/S
ADDRESS ��� ✓ ,��9(
OWNER CONTR.
TELEPHONE NO.
�"�?�.r
❑ FOOTING ❑ PLUMBING RI �$ITE INSPECTION
❑ FRAMING ❑ MECHANICAL ❑ EXCAV./GRADING/FILLWG
� ❑ INSULATION ❑ WATER HOOKUP ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. ❑ METER SET/TURN ON ❑ LICENSING
W ❑ FINAL ❑ SEWER HOOKUP ❑ COMPLAINT
�L ❑ PROGRESS ❑ SEPTIC INSTALL. ❑ FOL�OW-UP
� ❑ DEMOL. ❑ SEPTIC MAINT. ❑ SEPTIC FINAL
O ❑ FIRE PREV. P �
Z
Q COMMENTS:
z
�
J
Q
W
_
Q s
� - '\
�
W
�
�
J
O
�
�
O
�
W
�
Q R
� � J � �
� -���
w \
�
j �
a
W
�
W �ORK SATISFACTORY: PROCEED ❑PHOTO TAKEN
O LJ CORRECT WORK&PROCEED
U ❑ rORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
❑CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
❑ STOP ORDER POSTED. CALL INSPECTOR.
❑ INSPECTION REQUIRED. CALL TO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. on site
I nspector 473-7357
White Copy/Inspecto ' File Gold Copy/Site Notice