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HomeMy WebLinkAbout1977-06-29 Water Hook Up #4849City Permit I? 4849 Contractor res s Address Owner �"""'� ` Address 945 C �LC'Cze�CC-rt State License No Parcel No. Section No. Plat No. _ Other Description: C, v License No GENERAL PERMIT CnY OF ORONO Crystal Bay. Minnesota 473-7357 _mac Date r 2 % — 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) Instill Plumbing Systems: Install Sewage Disposal Systems: Install Water Hookup: (City) Install Water Supply Systems: (Well) SAC 7s- o// Fee S ©� Fee S Fee $ Fee S Signature ant Fee S Fee S Fee $ State Surtax Fee $ 1 S Total Amount Paid to City _ . . ... . Ice S Signature 31 City Official Code. White -Fie Copy: Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant'% Re,eipi