HomeMy WebLinkAbout1981-12-02 Permit, Move House #6580City Permit Na 6580
Contractor t i L L S'Tt.' 13m� Address
Owner d✓LLk S gik LG A420 Address _M3� F A- rr` •aKC-
State License No.
Parcel No.
City License No.
GENERAL PERMIT
!� QF 0110No
Crystal Bay, Minnesota
473-7357 Date
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.
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Water Meter:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Install Water Hookup: (City)
Fee S
Install Water Supply Systems: (Well)
Fee S
Signature ofap�eNean
SAC Fee S Signature of City
State Surtax: Fee S
sz .
Total Amount Paid to City ......... Fee S "
Code: White -File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt