HomeMy WebLinkAbout1978-10-31 Permit, New Water Well #5393city PfermltN?5393
Address .
State License No,..City License No..
it
4 GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357
Parcel No---------
Section No-------------------Lot.
-r-
. Block., Subdivision
» .. Plat No.
'‘ Other Description:
1 hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used,
shall comply with the Gty Code of Orono applicaUe thereto, and shall include all additional specifications as listed
below.
/y
—
Water M«ler:
Sewer Hookup: (City)
laitiil Pliunbiflc Systems:
Inital Sewife Disposil Systems:
Instil Water Hookup: (City)
Install Water Supply Systems: (Well)
SAC
State Surtax:
Fees,
Fees
Feel
Fees
Fee S
Signature of applicant
Fee S
Fees ____________
Fees
Signitu^9ratyO(Tkial
Tout Amount Paid to City.....................Fee S
Code: White-File Copy; Canary-Inspector's Copy; Pink>Finance Copy; Gold*Appilcant's Receipt
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