HomeMy WebLinkAbout1978-06-29 Permit, Septic System Add #5235City Permit 19 5235
Contractor !!Q J 1)PM
CUP_ 8/er'5--
Address
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Owner_ 24_�&es2FL/_
Address
Pnin /U- &D A)
State License No. City License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357
Block Subdivision
Date
%�- 29--2g
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:
Fee $
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fec $
Install Sewage Disposal Systems:
Fee S 2
Signature of app •ant
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well)
Fee $
SAC
Fee $
S allure of City ffic'
State Surtax:
Fec S
Total Amount Paid to City .........
st'
Fee $
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt