HomeMy WebLinkAbout1986-8391 - repair GENERAL PERMIT �ITYPERMITNO. 8391 �
CITY OF ORONO c�� j����,
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner � �� Ct GtT�� Address �L� /�����,�T� �/ �-�r�C �ic�
Contractar L�u n e.� l�'��� Address V'1'��-pi�i cc�n
City License No. ��� State License No.
REMARKS AND SPECIAL CONDITIONS
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 Q 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 L""�t�
State Surchar e: Fee $ d��
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 ��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
�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
codes �aior health department regulations, �a �nau be This permit is not valid until the proper fee is paid and
subject to inspection, approval or rejection by the City. lt 1S a roved b an authorized Cit Official.
Whenever so oxdered, the undersigned agrees to correct pp Y Y
any work found to be in violation of the conditions of
this permit.
Sig ature of Ap icant Signature of City Official
�
Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt
DATE TIME
ITY OF ORaNO CALLED IN �' I�7r��
INSPECTION NOTICE SCHEDULED �_a��� ���
PERMITNO. cOMPLETED � � ��� �� - ��
ADDRESS � � �r—'�=�/ '� \�
OWNER CONT . � v� r
TELEPHONE NO. �--l�-f�— `��R�
❑ FOOTIN�:, � PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING ❑ PLUMBING FINAL ❑ EXCAV./GRADING/FILLING
j; ❑ INSULATION ❑ MECHANICAL � LAKESHORE/WETLANDS
I� r7 WALL BD. 7 WATER HOOKUP ❑ LICENSING
� ❑ FINAL ❑ METER SET/TURN ON ❑ COMPLAINT
Q � PROGRESS ❑ SEWER HOOKUP ❑ FOLLOW-UP
� ❑ DEMOL. ❑ SEPTIC INSTALL � SEPTIC FINAL
Q ❑ FIRE PREV. O)SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER
� �WELL TEST PUMP ❑ __ ___ _ _
� COMMENTS:
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�W ❑ WORK SATISFACTORY: PROCEED ❑ PHOTO TAKEN
❑ CORRECT WORK&PROCEED
V ❑ CORRECT 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 .;�7357
White Copy/Inspector's File Gold Copy/Site Notice