HomeMy WebLinkAbout1978-05-13 Permit, Water Supply System #5197City PermitN? 5197
Contractor;! �1L� C� /mot _ . ��/ �i Address
Owner s `!�� Address 117Y 4f-��„
State License Na.
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357 /j � 7Y
Date
Parcel No.
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.
1L1
Ly
Water Meter:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee S applicant
Install Water Hookup: (City)
Fee $ I Jiptisrt"
Install Water Supply Systems: (Well) Fee S 4i0.
SAC Fee S S of City Offi
State Surtax: Fee $ 1 SO — «..0, • �� �� .f
Total Amount Paid to City . .. . .... . Fees .20• SD
Code: White -File Copy; Canary Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt