HomeMy WebLinkAbout1976-11-30 Permit, Sewer Hookup #4714City Pfermit^O 4714
Contractor__
Owner______^c£a
Address.
Address 3o
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
Date.
Block.Subdivision.
I hereby agree that, in case a permit is granted, all work which shall be done and all matenals which shall be used,
shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
aJ /M-?C
Water Meter:
Sewer Hookup: (City)
Install Plumbing Systems:
Fee$
Fee$
Fees
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
SAC
Feel
Fees
Fees
Fees
State Surtax:Fees ,sro
Total Amount Paid to City................
Signature71^,
Signature of City Offici
Code: White-File Copy; Canary-Inspector’s Copy; Pink-Finance Copy; Goid-Applicant’s Receipt