HomeMy WebLinkAbout1976-11-19 Permit, SAC #4708Contractor
Owner D i0 " � M
State License No,
Parcel No.
City Permit N?
Address
N c L_ So Address A 0'31D � D
City License No.
GENERAL PERMIT
CITY OF ORONO
4708
Crystal Bay, Minnesota
473-7357
Date
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.
Water Meter:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Signature of applicant
Install Water Hookup: (City)
Fee $
,---,,,:-Aj,,._
Install Water Supply Systems: (Well)
Fee $
SAC
Fee S J �O. D O
Signs o t yypff�icia, ll
State Surtax:
Fee S
Total Amount Paid to City ......... Fee $ 3`sn • O n
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt