HomeMy WebLinkAbout1976-09-14 Permit, Sewer Hookup #4605City Permit N° 4605
Contractor Address
Owner J Address�L_��
State License No. City License No.
GENERAL PERMIT
LTI'Y OF ORONO
Crystal Bay, Minnesota
473-7357 76
Date (o
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.
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Water Meter: Fee S
Sever Hookup: (City) Fee $ O- D O
Install Plumbing Systems: Fee S
testa Sewage Disposal Systems: Fee $ Si of applicant
Install Water Hookup: (City) Fee $
Install Water Supply Systems: (Well) Fee $
SAC Fee S _ Signature of GIN OfE
State Su-ax: Fee S . 6-0
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Total Amount Paid to City ......... Fee S J O
Code: White -Fib Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt