HomeMy WebLinkAbout1981-02-06 Permit, Water Supply System #6258City Permit N? 6258
Contractor J`G 0CA WF—LL Co
Address
MT"
1AVA
Owner RF_1] F i E L[Y kam �_:7
Address —P;?3'7
S
Q& v I ve, /, q
State License Nr
Parcel No.
City License No.
GENERAL PERMIT
GTl'Y OF ORONO
Crystal Bay, Minnesota
473.7357 n2 _ �o ` p I
Date OO
Section No. Lot Block
Plat No.
Other Description:
Subdivision
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 Motor:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Storage Disposal Systems:
Fee S
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Weil) Fee S ,�?Q • 4111110
Signature of applicant
i
SAC Fee S Signature of ity Officia
State Surtax: Fee $ 1 5-0 —
Total Amount Paid to City ......... Fee S - so
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt