HomeMy WebLinkAbout1978-02-28 Permit, New Water Well #5089Contractor
Owner (I -7)^I 5 t,/
State License No.
Section No
Parcel No
Plat No
Other Description:
Lot
Address
City Permit No
I • 1
City License No.
GENERAL PERMIT
CNY OF ORONO
Crystal Bay, Minnesota
473-73$7
Block Subdivision
Date /%
1 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:
Sewer Hookup: f0ty)
Install Plumbing Systems:
Install Sewage Disposal Systems.
Install Water Hookup: (City)
Install Water Supply Systems (Well)
Fee S
Fee $
Fee $
Fee S
Fee S
Fee $ L(6 tw - n
Signal of applicant
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SA(' For $ _ S
State Surtax Fee S _ •y.L�_�1
I otal Amount Pod t.) City Fee S
.r Wtute-File Copy, Canary Inspector's ( op). Pink-Financv Copy: GoW-Apph, ant'. Receipt