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HomeMy WebLinkAbout1988-03-28 Permit, Replace Well #000696PERMIT CITY OF ORONO PERMIT TYPE: SEWER h WATER 1335 Brown Rd South • P O Box 66 Permit Number 000696 Crystal Bay. Minnesota 55323 Date Issued 0 00696 ii 1612) 473-7357 SITE ADDRESS: 3780 BAYSIDE RD Sewer h Water Permit Type WELL Sewer b Water Work Type REPLACE EXISTING FEE SUMMARY: Base Fee $.00 Surcharge ---------- 5-59 Subtotal $.50 CONTRACTOR: -- Applicant -- STEVENS WELL DRILLING CO 44792591 6240 HWY 12 W YAOI C of AIAI MAI ccQC0 H WELL --------$:4_44 Total Fee $30.50 OWNER: ANDERSON HAZEL .780 BAYSIDE RD PMV CTAT GAV MAI AE:ANDON WELL AND DRILL NEW WELL - SITE MUST VE OK'D BY CITY STAFF SEND COPY OF STATE WELL RECORD THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS L SPECIFIED AND AGREES TO 00 ALL WORK IN STRICT COMPLIANCE WIT14 ALL CITY OF ORONO ORDINAN ND STATE OF MINNESOTA E:UILDING (UDE RE4UI'EMENT- _ _ � .�� _ __ �I �l lisc7 9ATaURE PPLICANT PERMITEE SIGNATURE ISSUED BYG