HomeMy WebLinkAbout1977-11-14 Permit, Septic System #5012Clq RmtitNi 5012
Contractor ,[`�~�t�c` ^J as C Address
Address ' 1
owner �J –
State Liceme No. —Cit) License No.
GENERAL PERMIT
(QTY OF ORONO
Crystal Bay, %Iinnesota
473-7357
Date _
Parcel No
Section No. Lot Block Subdivision
Mat No.
Other Description.
1 hereby agree that, in cast a permit Is granted, all work which shell he done and all materials which shall he used,
shatl comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
water Meter
Fee S _.
Sever Hookup 1Ciry 1
Fee f
Inatdl Mumbing Sy%I,ms:
Fee f
Install Severe 1 ,W mal Sy teems
Fees fin• 0
Stine ^ ptia
Install water Hookup airy i
Fee S
["stall water Suppl) St ucm+ (Nell)
Fee
SAC
Fee f
SI a tel 0t) 0fl 1
\
State Surtax
tee f C
T
Total Amount Paid to City .. Fee f IC -6 C'
Code white-F'W Copy. Canary-Ingector'IC opy. Pinkfinance Cupy: Gold-AppUcaai's Rnrlpt