HomeMy WebLinkAbout1981-08-31 Permit, Sewer SAC #6438Contractor
Address
City Permit N? _ 6438
Owner_ lJruc�,_ :Qg: iZ1k%j LAIZ (L Address 5796 3P, -e677_ - A v C
State License No. City License No.
GENERAL PERMIT
CPrY OF ORONO
Crystal Bay, Minnesota
473.7357
Date
Parcel No.
Secti-n No. Lot Block Subdivision
Plat No.
Other Description:
8 -31 -Fe
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.
Water Meter:
FCC S
Sewer hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee $
Install Water hookup: (City)
Fec $
Install Water Supply Systems: (Well)
Fee $
SAC
Fee $
State Surtax:
Fee $
Total Amount Paid to City .........
Fee S
igna r of applicant ,r '
Sig�of
Code: White -File Copy; Canary-Inspectot's Copy; Pink -Finance Copy; Gold -Applicant's Receipt