HomeMy WebLinkAbout1986-8480 - filll for garage location GENERAL PERMIT CITYPERMITNO. g4HO �
CITY OF ORONO �-
P.O.BOX 66 Date
CRYSTAL BAY, MINNESOTA 55323
(612) 473-7357
Owner d� ����/��P� Address � � � �� `��
Contractor �`�� Address
City License No. State License No.
REMARKS AND SPECIAL CONDITIONS
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PERMIT TYPE AND FEE: ❑ NEW ❑ ADDI ION ❑ REPAIR
Inside Plumbing (#fixtures_) Fee $ Water We11 Fee $
Water Meter (Size) Fee $ Mechanical Equipment Fee $
Meter#
Remote# _ Moving �Lifting Buildings Fee $
M�micipal Water Connection Fee $ _ Land Alteration (Excavation, Fee $ �� '��
� Grading, Filling, etc.)
❑Copper
Mu�licipal Sewer Connection Fee $ _
Fire Fee $
❑ PVC ❑Cast n 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 ��
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 perxn:t 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
�oaeS and/or he�ra� department regulations, �a snau be This permit is not valid until the proper fee is paid and
subiect to inspection, approval ox reiection by the 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.
S�i�re Qf�Applicant Signature of City Of�cial
C�CifL.� , ��7�y�
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Code:White—File Copy Canazy—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt
CfIECK OFF LIST FOR ISSUl1NCE OF PERMITS
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Address : � ��i ,�1 ��� ��-E-' , � ��
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Initial Area of Review Rem,�
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Building Code Review � ��� '��` �''
f '� Zoning Review �/
7..��-c�(r�
Access
� a ) , State
_� b) Hennepin County
, _� c) City (Public Works Dept)
. _� d ) Private Roads .
(Publac Works Dept)
Utilities (Public Works Department)
_� a) Sewer
� b) Water
�� Septic Review
� MCWD
•.� LMCD
�_ Special Grading Review �(--���i�� �(�L C'F�ZLu2-�-
/ Engineer' s Review J°r���x1sL � /sSc.-��-��
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�/ Attorney's Review
� Special Assessments
Things to be noted on the permit:
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