HomeMy WebLinkAbout1979-10-19 Permit, Water Well #5777City Nrtttit N® 5777
Contractor SraP Wei L- Address #wy 7 M rKA
Owner e&p W HVWA4E2tnt Address 7--2-q0 pe-ViN 1AA)E
State License No.
Parcel No.
City License No
GENERAL PERMIT
GTI'Y OF ORONO
Crystal Bay, Minnesota
473.7357 Date /Q _ 1 9 - 79
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 $
Install Water Supply Systems: (Well)
Fee $
SAC Fee f S' afore of ' y tcial
.ro
State Surtax: Fee $
Total Amount Paid to City ......... Fee $ 2,12
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt