HomeMy WebLinkAbout1977-05-04 Permit, Water Hookup #4797Conti
Owne
State
Parcel No.
City Permit N? 4797
Address r
Address Os
City License No,
GENERAL PERMIT
CI'i'Y OF OFtONO
Crystal Bay, Minnesota
473-7357
Section No. Lot Block Subdivision
Plat No.
Other Description:
Date �- / / %
1 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:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
SAC
Fee S
Fee S
Fee S
Fee S Signatu .+i�
Fee S D P s
Fee S
Fee S
State Surtax: Fee S
Total Amount Paid to City . .. . . . .. . Fee $ O
Sig of it Official
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt