HomeMy WebLinkAbout1978-06-14 Permit, New Water Well #5205City Permit.io 5205
Contractor �+4LY�7eS[�� Address /LT a IkX % 7- I��c kFe•a.�
Owner IPA LE:^,I Address ? 7 C, N
State License No.
Parcel No
Section No. Lot
Plat No,
Other Description:
City License No.
GENERAL PERMIT
GTI'Y OF ORONO
Crystal Bay, Minnesota
473.7357
Block Subdivision
Date 6 — %,1/- 7 23
hereby agree that, in case a permit is granted, all work which shall be dr,ne 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.
t"1 OF S'T74TLr "e C_ X,--Zp./s4) , M a .4 5 'T 9 it .S u d /h 1'T%LSD -7– 2 P
Tater Meter:
Fee $
Sewer Hookup: (City)
I cc S
Install Plumbing Systems:
rcc S
Install Sewage Disposal Systems:
Fre S
Install Water Hookup: (( ty)
Fee S
Install Water Supply Systems: (Well)
Fce $ Z�
SAC Fee S Si nature 4 (1 t ON I
State Su'tax Fee S � �� f •—�
S�
Total Amount Paid to City . ....... Fee S O
Code: white -File Copy; Canary inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt