HomeMy WebLinkAbout1978-03-14 Permit, New Water Well #5104CContractor
Owner
State License No.
Section No.
Parcel No.
Plat No.
Other Description:
City Permit N? 5104
Address /
Address %o` !L11
City License No.
GENERAL PERMIT
cNY of ORONO
Crystal Bay, Minnesota
473-7357 / ! — 7P
Date
Lot Block Subdivision
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
Sewer Hookup: (City)
Install Plumbing Systems
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
1A(
State Surte �
Total Amount Paid to City .........
Fee $
Fee S
Fee S
Fee $
Fee S
1-1
Fee S " z7t
Fee S
Fee S�
Fee S
Signaturkof Cit Offal, 1
Coda: White-Flla Copy; Ctnary-tepedos's Copy; Mak-Finance Copy; Gold -Applicant's Receipt