HomeMy WebLinkAbout1979-01-12 Permit, Water Well #5462City Permit No 5462
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State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
_' ENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357 /_ /Z _ %q
Date /
Block Subdivision
6
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.
6etPr of _cT Y __ WLPLL QEG02'D To C/ TY
Water Meter:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Instal' Water Supply Systems: (Well)
SAC
State Surtax:
Fee $
Fee S
Fee $
Fee $ Signature of applicant
Fee $
Fee S
Fee S Signature of Cit ffic' 1
Fee S
Total Amount Paid to City ... ...... Fee S _
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt