HomeMy WebLinkAbout1979-06-07 Permit, SAC Only #5589City Permit IN? 5589
Contractor Address Owner C'c t°A `� b �� C�7 VA Address _3 V ( —7
C R us-t A L `P Lae c
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 7
Date Cv 7?
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.
SAC-
G
Water Meter:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
�Sign� of applicant
Install Water Hookup: (City)
Fee S
'
Install Water Supply Systems: (Well)
Fee S
SAC
q�_51
Fee S
Signature o
-2f.&ILLY Offici
State Surtax:
Fee $
--
Total Amount Paid to City .. . ....
. Fee S
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Cop} ; Guld-Applicant's Receipt