HomeMy WebLinkAbout1978-07-18 Permit, Septic System #5246City Permit Na 5246
Contracto -A Address
Owner �11Address ,3(036 tr
47
State License No,
Parcel No
Section No.
Plat No. _
Other Description:
City License No
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357 �t7
Dateo a4 -/ ff *1
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 City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
Water Meter: Fee f
Sewer Hookup: (City) Fee $
Install Plumbing Systems: Fee $
Install Sewage Disposal Systems: Fee S ao• Signature of applicant
Install Water Hookup: (City) Fee S
Install Water Supply Systems: (Well) Fee $
SAC Fee f �f(cyficial
State Surtax: Fee S � s�
Total Amount Paid to City .... ..... Fee S n^l,,
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt