HomeMy WebLinkAbout05-25-1979 Permit, Water Well #5572City Permiti`j ? 5572
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Owner lM.2c , O HNX0,10 Address /3B fz tg At n 4 d 67'e
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357 Date
Block Subdivision
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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.
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Water Meter:
Sewer Ilookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
FCC S
FCC $
FCC S
Fee S
FCC S
c.o
FCC $ Z�
-31 a� "! f yppiicant
SAC FCC S Signature of Cit Official
State Surtax: FCC S
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Total Amount Paid to City ......... Fee S I�
Code: whlte-File Copy; Canarylnspector's Copy; Pink•ITinance Copy; Gold •Applicant's Receipt