HomeMy WebLinkAbout1986-8581 - "New" something GENE AL PERMIT CITYPERMITNO. � s5s�
CITY OF ORONO
P.O.BOX 66 Date
CRYSTAL AY,MINNESOTA 55323
( 12)473-7357
�` — O,
Owner r iv Address `� / �. e. • •
Contractar �I r�� 1�� ddress
City License No. State License No.
REMARKS AND SPE IAL CONDITIONS
PERMIT TYPE AND EE: �NEW ❑ ADDITION ❑REPAIR
Inside Plumbing(#fixtu es_) Fee $ Water Well Fee $ s���
Water Meter(Size_) Fee $ Mechanical Equipment Fee $
Meter#
Remote# Moving/Lifting Buildings Fee $
Municipal Water Conne tion Fee $ Land Alteration (Excavation, Fee $
Grading, Filling, etc.)
❑Copper
Municipal Sewer Conne tion Fee $ Fire Fee $
❑ PVC ❑ ast n Sprinkler System (Fire) Fee $
MWCC SAC Charge Fee $ Other: Fee $
On Site Septic System Fee $ After-the-fact Investigation Fee $
ACKNOWLEDGEME T TOTAL
The undersigned he by acknowledges receipt of this limited
permit, including cceptance of all special information,
terma, conditions or requiremeats watten above. The State Surcharge: Fee $�
undersigned unders ds and a�ees under penalty oP law
that thia permit is strlctly limited in acoDe to the work,
activity or imgrov ment specified; that this Hermit doea
not �ant any au ority to do wa�k or activities requixina Total Amount Paid to City Fee $_
separate permit aP rovals; and that this Dermit doea not �
grant authority t violate any Drovision of anY CitY
ordinance or State aw,rule or regulation.All work shall be
done in strict com lisnce with all City ordinances,buildinQ
codes and/or heal devartment reaulations, and sheu be This permit is not valid until e proper fee is paid and
subiect to inspect[ n, apDroval or relection by the c;zr. it is approved by an authorized lty �f�1C1�.
Whenever so orde d, the underei�ed a�{rees to correct
any work found be in violatlon of the conditions of
Ehis permit.
Signature of Applic t Signature of City Offic'
.___.—!
Cod :White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—ApplicanY Receipt