HomeMy WebLinkAbout1994 - 006078 - SAC only PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number:
Orono, Minnesota 55356-0815 Date Issued:
1 2/ 4
SITE
017 9(612) 473-7357
:356 WESTLAKE ST
P . r : 05-1 1.:2-2:'.:-2:3-001 5
DESCRIPTION:
Swer & Water fl' rmit Type SAC ONLY
SewPr & WatPr Work TypP RESIoENCC
riTY OF ORONO
SrINANCE OFFICE
1222600000
01 (SEN 8&%00
CHECK TL S00.00
•r•Oli
.L,Y(174Arsie ETri
V LeVVA MVA 11uP.14.
REMARKS:
FEE SUMMARY:
Base Fee $800. 00
Iotal Fee $800. 00
CONTRACTOR: OWNER: - Applicant -
ANDERSON n 13 17,1
.5 6 WESTLAKE SI
ORONO MN 5556
THF UNDERsIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS
VFCIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF
L ORONO ORDINANCES AND STATE OF MINNESOTA RUILMING cODE RE-QUIREMENTS .
AS
4,
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE