HomeMy WebLinkAbout1981-09-24 Permit, Water Supply #6479City Permit N? 6479
Contractor �' ': Address L*Pl LeA
Owner �I/11 �E�'T� Address 50 DClp25�
State License No
Parcel No,
City License No.
GENERAL PERMIT
CPl'Y OF ORANO
Crystal Bay, Minnesota q
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 Mumbing Systems: Fee S
Instal Sewage Disposal Systems: Fee S Signature of applicant
Instal Water Hookup: (City) Fee S
Into Water supply Systems: (Well) Fee S
SAC Fee S Si ature grps%Off W /
state surtax: Fee S
SO
Total Amount hid to City ......... Fee S
Cob: Whit&Fla Copy; Canary-6mpector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt