HomeMy WebLinkAbout1981-11-05 Permit, Septic System #6540city Permit N? 6540
Contractor &La Address 3
Own,-r / '►7�- 1� ��— Address `f' -'5 -d
State License No. City License No.
GENERAL PERMIT
Crff OF ORONO
Crystal Bay, Minnesota
473-7357
Date -A57
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.
Water Meter: Fee S
Serest Hookup: (City) Fee S
Install Plumbing Systems: Fee S
Install Sewage Disposal Systems: Fee S _�� 5 . v� Sign::tyre Qf a t
Instal Water Hookup: (City) Fee S
Install Water Supply Systems: (Well) Fee S
SAC Fee S / /_ Signature t Ofticisl
_ ,l
State Surtax: Fee S • 5o
Total Amount hid to City ......... Fee S �_ 50 X
Code: White -Fib Copy; Chary -Inspector's Copy; INr once Copy; Gold -Applicant's Receipt