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HomeMy WebLinkAbout1985-09-18 Permit, Water Well #8093GENERAL PERMIT CITY OF ORONO P.O.BOX (><, CRYSTAL BAY. MINNESOTA 55S:3 (6I:h73-7.157 CITY PERMIT NO. 8093 D... A,.p.u. t<v/i______Addg.« City License No._______/O ^ ^ • ^ -----------------------State License No.___________ Owner___ Contractor RFMARKS AND SPLCIAL CONDITIONS PERMIT TYPE AND FKfi: Inside Plumbing (#nxlua*s __| >i:W □ ADDITION Water Meter (Si/e__) Meter# _________ Fee S, Fee S. Remote Municipal Water C onnection □copper n Fee S. Municipal Sewer Connection □ Pvr Dcs, □_ MWee SAC Charge On Site Septic System Fee S_________ Fee $. Fee S_ □ repair Water Well Mechanical Equipment Moving / Lifting Buildings Land Alteration (Excavation. CJrading, Filling, etc.) Fee Fee S__________ Fee %__________ Fee S«._________ Sprinkler System (Fire) Other; ___________ Afler-the-fact Investigation Fee S. Fee S_ . Fee S, Fee ACKNOWLEDGEMENT r%9 bm^ I—H ____ * “ - r praaitv o( Um •TTlIrSt br di« at».________________ f fiKUom by I Signatua*'^*<^Applicjmt TOTAL State Suaharge: Total Amount Paid to City Fee S. Fee SY> Signaiu^of Gly Official^ y/v/x: