HomeMy WebLinkAbout5350 (Water Well)City Permit N? _ 5350
Contractor < -=E
V67U S U)CLL
Address
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Fee S
Install Sewage Disposal Systems:
Fee S
Owner G4-ADY.S
Ot song
Address
13yd Sae_nue_
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State License No.
Parcel No.
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357
Section No. Lot Block Subdivision
Plat No.
Other Description:
Date
M.- (,-793
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 S
Sewer lioakup: (City)
Tee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Install Water Hookup: (City)
Tee S
Install Water Supply Systems: (Well)
Tee $ ZC�
SAC
Tec S
S-0
State Surtax:
Tee S
�Lj�rpricaot
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Signature of ity Official
CD
Total Amount Paid to City ......... Fees 2-0 r
Code: White -Tile Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt