HomeMy WebLinkAbout1987-06-09 Permit, New Water Well #9041GENERAL PERMIT
CITY OF ORONO
CITY PFRMIT N° 9041
PO. BOX 66 Isle June 9, 1987
CRYSTAL BAY. MINNESOTA 55123
16121371.7357
Owner _ Gary Printup —T_ __. \ddns 1261 Briar Street
C(xw&. w __ Don Stoodo/l/a'a well \dthem —__!5306 Hwy No. 7
Ciw li�rw Nu. Mtka, MN 55345
REMARKS AND SPECIAL CONDITIONS
Staff to OX site of well,
Contractor must submit copy of State -well- record to City offices
PERMIT TYPEAM) IFI W'
Inde Plumhing olimun. - r IV;: S
Water drier ISrre _- _ t Ire S
Mcicr 11 - -- -- -
Remllte = - - –
Mumulml W2Ill•r l ttnnti•utrn
❑ ('441(xrr ❑ — --
111unkipal'-w%wr (•Imnlxtwxl
❑ IWC ❑ Cast ❑ _-
MN'CC SAC Chagw
On Site Spetk S%m m
ACKNOWLEDGEMENT
Ftx S
Fee S
fix S
I -c S -
ht taalnynd htrrin at►n.wMtlrt• 1—,rr .d IM IatlnrJ It+mu
a.lul..f at.tTuatt•all .I..tal ml..rn t— •mt• t.v.lnsrlt ..
rryun•tn+x• rnnm :., — lAt ttt k1.W1tn1 tu.k.tun1` NO ar —
tltttkr rentht.d btt that tht. rerm.l n Jrxdt hmaJ m..•r.• r,tM rtr►
attrtat .v mrr. t,ftna tr.. d..) that thn Irma Sas r.4 ryanl ant
attdn int e. S ...► t. atn t rtn uyt�nt f �irratr return aryrr nah anti
thal An r.•rma S.� nr,raM atallrrdt b,, twit ant pn — dant l nt
.wlamm-w Matr lar ndr.r. ftrilatme \n r r+l.lull fe tl, rtn.tnt
tt.atrdaantd% AN 1 a• .vtl.naakm t%AJww tt.ity and r. Ik-Akh
tlrrunmrnt nrulat.— and Jun M •44t.1 at am—ah*
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"Al.. I.t thr ('r1t Nhrn-tn ...rtk'trtl to. u..lrr.gnttr Jwft� 4t
ttrmr ant rtv►N�lt.-h:ntw 1rr. yr.d the .. r.Lt. dttt�Ihn rt•tmu
Signature of Applwin(
1
1CC_ )! r_n
IITION ❑ REPAIR
%later Well
\krilanocal I•aiwpmcnt
I moatx Wixx1 Slltte
\hiring lifting Buildinp
land Atleratitm (F:uaWtatn.
Grading. Filling. etc.)
lkvign Retnw
Fire
Spnnkkr So,4cm (Fire)
(hher - -
Atn•r-1 lle430 Imv%uptilm
TOTAL
State Surcharge -
Intal x1riount NO it, l to
0
❑ REMODEL
Fa S 30.00
Foe S
Fee S
Fee S _
Fee S
Fee S
Fee S
Fee S
FCCS_
I -cc S
Fee S _ 50
Fee S 30.50
IN% riemi Is nett tand until the pntper fee is paid and It is appni%od
ht an autlxmml ( lt% Official.
Swignalu
F5�fw (It) OIr I 1
C4xk 111nrr I kle OIn Caron- milk&'. Caton host Ftntlxr (uln Gil - Appllani.ltnt+p