HomeMy WebLinkAbout1980-05-29 Permit, Water Well #5998City hrmit IN 0 5998
Contractor 6�/911,P..:r /�IV- Address n
Owner jya.,m r k- Address #6r l
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,
shaft comply with the City Code of Orono applicable thereto, and shall include al' additional specifications as listed
below.
Water Meter.
Fee S
Seiner Hookup: (City)
Fee $
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Install Water Hookup: (City)
Fee S
Install water Supply Systems: (WA)
Fee S 0o
SAC
Fee S
State Surtax:
Fee S .50
Total Amount Paid to City .... ....
. Fee S �,1� , 5 D
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Signature of City Official
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Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt