HomeMy WebLinkAbout1976 - 4657 - general permit ,
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City License No. License No. -
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, GENERAL PERMIT
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CITY OF ORONO
! Crystal Bay,Minnesota
4 473-7357 Date ie- Xg- 7(
Parcel No.
- �`} Section No. Lot Block _Subdivision
Plat No.
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Other Description:
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,: I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be :,
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shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
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7 0 CA---1 - -e-iec-eC— ,-4.-7- e-e-a---‘;'--/c_ ....e__,‘Y,
'' Water Meter: Fee$
Sewer Hookup:(City) Fee$
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Instill Plumbing Systems: Fee$
m Install Sewage Disposal Systems: Fee S 020/ CE' Si nature of applicant
;•; Install Water Hookup:(City) Fee S �i' 4ii/' `eJe-Gd(W)
Install Water Supply Systems:(Well) 1 ee$
SAC Fee$ Signature of City Official /�pr//,
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State Surtax: Fee$
r `_ - .Total Amount Paid to City Fee S e2B •�C
, Frvr, :Code:Wbite File Copy;Canary-Inspector's Copy;Pink-Finance Copy;Gold-Applicant's Receipt
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