HomeMy WebLinkAbout1977-01-25 Permit, Water Meter #4741City Permit I O 4741
Contractor l�O�lhL9y� J �� <<� Address
Owner_ J• fL e Address ✓ �� t�,C.c �Afl.
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357
Block Subdivision
Date
/- �_f - 7;�
I hereby agree that, in case a permit is granted, all work which shell 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.
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Water Meter: Fee S 60, N 0
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee $
Signature o appplic t
Install Water Hookup: (City)
t--ee $ eel
Install Water Supply Systems: (Well)
Fee $
SAC
Fee S
Signature of City Official
State Surtax:
Fee $
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Total Amount Paid to City .... .....
�7
Fee S / 5- . S C
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy, Gold -Applicant's Receipt