HomeMy WebLinkAbout1983-7063 - general permit • , ,
: -• GENERAL PERMIT CITY PERMIT NO. I
"-todi
,
'CITY OF ORONO
Date
P 0.BOX 66 •
':,'•'' ' CRYSTAL BAY,MINNESOTA 55323
(612)4734357
.... -
' O CeetUD 0/1CC
Owner Address 5c-A0 OP-ono 412c44L) • ,ii,-.1 ,'
1112,4v,14.0., vv..Isc.,,
Address inbUilri &Al
Contractor ...
l' 19' '',,, l' I , ••'„'City License No. State License No.
,Y ,,e•
REMARKS AND SPECIAL CONDITIONS
. ,. . • , .,
k•2 7-#..;.• ' ,
t: • • c...; (,•-• -•,
•
— .
PERMIT TYPE AND FEE: 0 NEW 0 ADDITION 0 REPAIR
• tj,:: •.-;.s,• , -- ., -
:4
Inside Plumbing(# fixtures_) Fee S On Site Septic System Fee $..---
'•.' :.'•,,,•; . • „.
',,'•'-
' • + WaterMeter(Size—) Fe $ Water Well Fee $---
te M i '
e r Mechanical Equipment ' ... .
ReinFee S
ff
t Moving/Lifting Buildings Fee $
: Uhl' cip-Li Water Connection Fee $—. .1 ••
t, '••• , rn n
Lj Copper Land Alteration(Excavation,
Fee $.-- .
Grading,Filling,etc.) . .
20 00
,..;Municipal Sewer Connection Fee $ .
. . . .
' '''''''%1 • PVC 0 Cast fl Other: Fee $ ,5
M.'.WCC SAC Charge Fee $ 4•125°° After-fix-fact Investigation Fee $
,1 k
-
ejlig-,0q
ACKNOWLEDGEMENT TOTAL ,
- ' 'A:4`.4...,.•••• The undersigned hereby acknowledges:ergot of this limited 1
ail special information. .
"an".'Inehmuns Tr'Prolmotnt. ..itt.. &b.. The -S-0
tetras.,aolidholis itezais and atom under „nolo of fon State Surch;Jge: Fee S—.4.---_....
,, ir_fr•-•' Underigill” Ur
'thatis tly limited in scope to the work.
aetivito,or Improvement somdfiedt that this permit does( Fee $ -111/4r6a
,,,noc pant any authorilr to do work or activities stI41
Total Amount Paid to City
do
'-•. ,•,,,,,t..,,,,-4,,,,..1•• JO iiiPalniodt,t,,IroplrOVvioiallitai and ythapet ovistothia 17 of any
any Cinot
en o
s i ',40. ,,,,,••grant
', ' •-•, :`,'''..`.•:ordinance or State law.:vie Or regulation.All work. Assn be
II,., `, , 4'.•-,."•:•,„.1`'''.."'.done In strict comPliallee with in City atdlnsncesti ns and shall
codes andlor health department !tibia It • This permit is not valid until the proper fee is paid and
or mieedon the City.
isubject to inegmiich• oPPrbytoowli d wanes conwt it is approved by an authorized City Official.
":: : '.,','wian7nrort‘sesouneIlka rr bet: violation of the conditions of
this permit.
, tul .. Signatu f City •4,1 40,1
silt' ature •plict
• •
( — trinut4 ii ./
/ . .
. _
,,, ,,„r,o•-•
.: 1••,,,--,4‘ i-t: , Code:White-Re Copy Canary-Inspector's Copy Pink-I:bunco Copy Gold- pplicant's Receipt .. ,
i!.:
'It I "tf; ".**.i 7,
... ...-....,...."*..
,..
.• f