HomeMy WebLinkAbout1977-07-26 Permit, Water Hookup #4882City PermitN?4882
Contractor Address
A ^
Owner Aupa/\Address,Z. I Casco
State License No.City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357 DateTr5j(kr2I.
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.
5T MeT£E
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Water Meter:Fees
OO
Sw-wer Hookup: (City)Fees
Install Plumbing Systems
Initall Sewafe Disposal Systems:
Fees
Fees
lattaU Water Hookup: (City)Fee S /
Signature 4>f api^ant yn jy
Instal) Water Supply Systems: (Well)Fees
SAC
State Soitax:
Total AniouBt Paid to Oty
I ee S
Feel
Signature o^ity OITidal
......................Fee S
0>4e; WMie-Fik Copy,Canary tntpecior*s Copy, Pink Fiiunte Copy ; CoU Appttcanfl Recetpi