HomeMy WebLinkAbout1979-10-03 Permit, Water & Sewer Hookup #5756City Permit 5756
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l^\t>rY\er^ iSigg^iT /Contractor.
Owner T\<o«r2.€7vJ/?ffi*TH
Address
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State License No.City License No.
GENERAL PERMIT
CITY OF ORONO
Parcel No.
Section No.Lot
Plat No.
Other Description;
Crystal Bay, Minnesota
473-7357 Date /o-%~y9
Block Subdivision
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be used,
as listed
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.
___________<AC 90
Witer Meter: Pec 5
Sewer Hookup: (City) Pee $
Install Plumbing Systems: Fee $
InstaU Sewage Disposal Systems: Fee $
InttaB Water Hookup: (City) Fee S
InMall Water Supply Systems: (Well) Pee S
SAC Fee S
State Surtax: Feel
Total Amount Paid to City.....................Fee J
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Signature of CityJOfTici
(3o4c: WhUe-FOe Copy; Caiuury-lnipeetor’s Copy; Pink Pinance Copy; G«4d-Apptkanfs Receipt