1986-06-24 Permit, New Water Well #8539

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GENERAL PERMIT CITY OF ORONO P.O.BOX 66 CRYSTAL BAY, MINNESOTA 55323 (612) 473-735`7 Own_r// L ZC <- 1� Address Contractor ` `-'' �� Address City License No. _ r State Lig REMARKS AND SPECIAL CONDITIONS PERMIT TYPE AND FEE Inside Plumbing (#fixtures_) CITY PERMIT NO. 8539 Date e ❑ NEW ❑ ADDITION ❑ REPAIR Fee S Water Meter (Size_) Fee S Meter# Remotel, Municipal Water Connection Fee S ❑Copper ri Municipal Sewer Connection ❑ PVC ❑ Cast MWCC SAC Charge On Site Septic System ACKNOWLEDGEMENT Water Well -- Mechanical Equipment Moving /Lifting Buildi Land Alteration (Exca Grading. Filling, etc Fee S -- -- a- Fee S re nkler System (Fire) Fee S After -the -fact Investigation The undersigned hereby acknowledges receipt of" limited permit. including acceptance of di special Information. terms, conditions or requirements written above. The undersigned understands and agrees under penalty of law that this permit Is strictly limited in scope to the work, activity or improvement specified: that this permit don not grant any autkodty to do work or activities requiring separate permit approvals: and that this permit don not grant authority to violate any provision of any City ordinance or State law, rule or regulation. AS work shall be done in strict compliance with all City ordb mcm. building codes and/or health department regulations, and sball be subject to inspection, approval or rejection bs the City. Whenever so ordered, the undersigned agrees to correct any work found to be in violation of the conditions of this peewit Signa re of pplicant TOTAL State Surcharge: Fee S �'"•yr� Fee S Fee S Fee S Fee S Fee S Fee S Fee S Total Amount Paid to City Fee Fee This permit is not valid until the proper fee is paid and it is approved by an authorized City Official. Code: White —I -Ile Copy Canary—inspector's Copy fink—Finance Copy Gold—AppNeaat's Rtiosipt rN :fa