HomeMy WebLinkAbout05-30-1980 Permit, Septic System Alteration #5999CityPcnnit 5999
Contractor.
Owner____
.Address,
. Address.
State License No..City License No--------------------------------
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357
Date.
Parcel No._____
Section No____________Lot.. Block..Subdivision.
Plat No.
Other Description:
I 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 City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
/7
__________4- /LsjO^ J)f>a ______
Water Meter:
Sewer Hookup; (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
SAC
State Surtax:
Total Amount Paid to City.............
Fees_________
Fees_________
Fee 5_________
Fees_________
Fees_________
Fees_________
Fees
Fees
Slgnp*^ of applicant .
SignaturcD^Ofy Officbl
Code: White-File Copy; Canary-lnipccloi's Copy; Pink-Finance Copy; GoId-Apjl-cant's Receipt