HomeMy WebLinkAbout1977-07-27 Permit, Water Supply System #4884City Permit No _ 4884
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State License No.
Parcel No.
City License No.
GENERAL PERMIT
CITY OF OftONO
Crystal Bay, Minnesota
473-7357 Date 7 ` ,2" / _ 7 7
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.
Water Meter:
Sewer Hookup: (City)
Ix1W ltumbing Systems:
Instal 3ewW Disposal Systems:
Instal Water Hookup: (City)
Instal Watt supply Systems: (WeU)
SAC
Fee t
Fee $
Fee f
Fee =
Signature of applicant i
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Fee f
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Mate Surtur: Fee f . s
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Total Amount hid to City ......... Fee f
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Cods- Mbit&Fra Copy; Canary -Inspector's Copy; hnk-Finance Copy; Gold-Appticant's Receipt