HomeMy WebLinkAbout1980-06-18 Permit, Water Hookup #6018r
City Permit ^ ®6018
Contractor.
Owner___
State License No.
Address
Address
City License No.
GENERAL PERMIT
ary of orono
Crystal Bay, Minnesota
473-7357
Date
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 includ-. all additional specifications as listed
below.
Water Meter:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
InMall Water Supply Systems: (Well)
SAC
State Surtax:
Total Amount Paid to City ...........
Fee $
Fees
Fee $ ..
ree f _Signature of a(>pli^nt
Fee S
Fee $___________
Fee $ _____________
Fee S .
..................Fee S
Code: White-File Copy; Caoary lnspector’s Copy; Pink-Fiiunce Copy; Gold-Applicant’s Receipt