HomeMy WebLinkAbout1980-02-08 Permit, Water Supply System #5917City Permit N? 5917
Contractor - S`Mtr'44 i/y6ZL Address %lyid h%7209
Owner 6�De_gw- _( Ac. MAJ Address to S S END
State License No.
Parcel No,
City License No.
GENERAL PERMIT
CffY OF ORONO
Crystal bay, Minnesota
473-7357 Z , Q
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
ale,
Install Water Supply Systems: (Well) Fee S �=
SAC Fee $
State Surtax: Fee $
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Total Amount Paid to City ......... Fee S �0 r
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Signature of applicant
Si atyre of Ci Offic' _ A
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Code: White -Fib Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt