HomeMy WebLinkAbout02-22-1979 Permit, Water Well #5482City Permit'? 5482
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State License No. City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357
Date.
Parcel No.
Section No. Lot Block Subdivision
Plat No.
Other Description:
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.
Install Water Supply Systems: (Well) Fee $ �w q . "
SAC Fee S Signatulsof,1 Official %
State Surtax: Fee S
Total Amount Paid to City ......... Fee S Zd • 5-0
Code: White -File Copy; Canary -Inspector's Copy: Pink -Finance Copy; Gold -Applicant's Receipt
Water Meter:
Fee $
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee $
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M)hcanAt}�
Install Water Hookup: (City)
Fee S
' e
Install Water Supply Systems: (Well) Fee $ �w q . "
SAC Fee S Signatulsof,1 Official %
State Surtax: Fee S
Total Amount Paid to City ......... Fee S Zd • 5-0
Code: White -File Copy; Canary -Inspector's Copy: Pink -Finance Copy; Gold -Applicant's Receipt