HomeMy WebLinkAbout1978-09-21 Permit, Sewer Hookup #5321r
Contractor.
Owner___
, Address
. Address
City Permit ^?5321
State License No..
GENERAL PERMIT
CITY OF ORONO
City License ^o.m
Crystal Bay, Minnesota
473-7357 t>,i. 9-
Parcel No..
Section No..
3^.
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.
Water Meter:Feel
Sewer Hookup: (City)Fees
ImtiU Plumbing Systems:Fees
Install Sewage Disposal Systems:Fees Signature of applicant ^ ^
Install Water Hookup: (City)Fees
Install Water Supply Systems: (Well)Fees m
SAC
State SurUx:
Fees
/r*-^ • j —
Signature of City Official>^^^^^^
l ee 9 0
Fees Y/Total Amount Paid tj Gty...................
Code: While>Flle Copy;Caaity-Inspectot*s Copy; Pink-Finence Copy; Gold-AppUcant ’i Receipt