HomeMy WebLinkAbout1978-08-23 Permit, Septic System #5289City Permit.l? 5289
Contractor dei Address C:�t,[�f .L+
Owner " _" Address 'a,►,.
State License No.
Parcel No.
City License No,
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357
Section No. Lot Block Subdivision
Plat No.
Other Description:
Date11.t & f
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 ail additional specifications as listed
below.
Water Meter:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee $ _.-20,60
Sig re of applicAnt�
Install Water Hookup: (City)
Fee S
Install Water Supply Systems: (Well)
Fee $
SAC
Fee $
i of City or ' I
State Surtax:
Fee S J-5,19
W
Total Amount Paid to City . ... ....
. Fee S c '-SO
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt