HomeMy WebLinkAbout1979-07-24 Permit, SAC #5647City Permit N? 5647
Contractor
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Owner 61ka Address_Elm 5 T•
State License No. City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357
Parcel No.
Section No. Lot Block Subdivision
Plat No.
Other Description:
Date A!Z
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.
SAT
Water Meter:
Sewer Hookup: (City)
Install Plumbing Systems:
Instal Sewsp Disposal Systems
Instal Water Hookup: (City)
Fee S
Fee S
Fee S
Fee S
Fee S
Instal Water Supply Systems: (Well) Fee S
DO
SAC Fee f Z
State Surtax: Fee S
Total Amount Paid to City ......... Fee S Oo
Signature of applicant
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Code: White -File Copy; Caeary-lespeotor's Copy; Pink -Finance Copy; Gold -Applicant's Receipt