HomeMy WebLinkAbout1981-07-21 Permit, Septic System #6382City Permit Na 6382
Contractor % L N it'►MB/NC_ �� V?CES �fc—Address
Owner Hori1£' S' Address .L r-_&ce4q ,Z) eiVE
State License No.
Parcel No,
City License No.
GENERAL PERMIT
CITY OF ORONO
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:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
Fee $
Fee $
Fee S
O [7
Fee $_
Fee $
Fee S
Signature of applicant
SAC Fee S Signature ity fficial
SM
State Surtax: Fee S
SO
Total Amount Paid to City . .. . . ... . Fee S
Code: White-FUe Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt