HomeMy WebLinkAbout1980-05-21 Permit, New Water Well #5995.•’I
City Permit 5995
Contractor ^>77>£>OCA _
Owner J<^4A^ST¥=ie
Address _____________
Address -5?, /^filaLuAJ
State License No.City License No.
GENERAL PERMIT
CITY OF OBONO
Crystal Bay, Minnesota
473-7357
Date
.-A
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,
shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
^TtL
Water Meter:Fee$
Sewer Hookup: (City)Fee $
Install Plumbing Systems:Fee $
Install Sewage Disposal Systems:Fee $
Install Water Hookup: (City)Fee $
Install Water Supply Systems: (Well)Fee $
SAC Fee S
State Surtax:Fees
Total Amount Paid to City................
»—y -!T®
. . Fees ----
Code: White-File Copy; Canary-inspector ’s Copy; Pink-Finance Copy; Gold-Applicant ’s Receipt