HomeMy WebLinkAbout1979-10-03 Permit, SAC #5751City Permit N •e
575
Contractor (,A.) l R. rt.,e Address SPtiNc, &--it
Owner WA#JDA 2Ca4F/4FE&& Address_ZVeO L7w A1&*J00Z1Y
State License No.
Parcel No.
Section No.
Plat No. _
Other Description:
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357 Date /4 - 3 - 79 —
Lot Block 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 Uty Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
Muter Meter:
Sao ar Hookup: (C:ty)
install Plumbing Systems:
lastal SawW Disposal Systems:
Instal Muter Hookup: (City)
Fee f
Fee f
Fee f
Fee f
Fee f
Install Water Supply Systems: (well) Fee f
sap
SAC Fee f
State Surtax: -se f
L' CPO
Total Amount Paid to City ......... Fee f
signature of cep nt i00e�
c
Code: Wldt►Faa Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt