HomeMy WebLinkAbout1984-7602 - new septic GENERAL PERMIT CITYPERMI�NO. �sO�
CITY OF ORONO a
P.O.BOX 66 Date �/ `����.
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CRYSTAL BAY, MINNESOTA 55323 � ' "�� a�°�
(612) 473-7357 ����a�
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Owner ���� [/��/V Address ��7�.C� �X S'7- � ,
Contractor ��y J�,�Sb,� �X G � Address ��/N�
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
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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: 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 irtformation,
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, S—�
activity or irrtprovement specified; that this pertnit 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 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 permit.
Signature plic�iar t Signature o�.�ity Official
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Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt
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CITY OF ORONO cA��Eo-irv '/
INSPECTION NOTICE scHEou�Eo ��'=�Y
PERMIT NO. _ coMP�ETEo
ADDRESS � CJ �:�
OWNER ��1 ��- CON ` �
TELEPHONE N, �
❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTIO
❑ FRAMING ❑ MECHANICAL ❑ EXCAV./GRADING/F LING
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� ❑ WALL BD. ❑ METER SET/TURN ON ❑ LICENSING
❑ FINAL �WER HOOKUP ❑ COMPLAINT
� ❑ PROGRESS SEPTIC INSTALL ❑ FOLLOW-UP
� ❑ DEMOL. ❑ SEPTIC MAINT. O SEPTIC FINAL
Q ❑ FIRE PREV. C WELL TEST PUMP O FIREPLACE/WOOD BURNER
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
❑ STOP ORDER POSTED. CALL INSPECTOR.
❑ INSPECTION REQUIRED. CALLTO 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
DATE TIME
CITY OF bRONO cA��E�-iN �
INS�ECTION NOTICE SCHEDULED ��
PERMIT NO:_.__ _ connP�ETE� � - � --�-��
ADDRESS ���� ��C
OWNER bL—�v� CONTR. - �
TELEPHONE NO.
❑ FOOTING p PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING ❑ MECHANICAL ❑ EXCAV./GRADING/FILLING
� ❑ INSULATION ❑ WATER HOOKUP ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. ❑ METER SET/TURN ON ❑ LICENSING
� FINAL ❑ SEWER HOOKUP ❑ COMPLAINT
�l ❑ PROGRESS �EPTIC INSTALL. ❑ FOLLOW-UP
� ❑ DEMOL. - ❑ SEPTIC MAINT. ❑ SEPTIC FINAL
O ❑ FIRE PREV. C1 WELL TEST PUMP � FIREPLACE/WOOD BURNER
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❑ CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
❑ STOP ORDER POSTED. CALL INSPECTOR.
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. on site
Inspector _ 473-7357
White Copy/Inspector's Fi Gold Copy/Site Notfce