HomeMy WebLinkAbout1981-09-17 Permit, Water Well #6469City Permit NO 6469
Contractor
W Qy _ Address
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Owner .oAijt� c.. J7` Address / a 9 S
State License License No.
Parcel No.
City License No,
GENERAL PERMIT
CPI'Y OF ORONO
Crystal Bay, Minnesota
473-7357 QQ ``
Date—.1� � %
Section No. Lot Block
Plat No.
Other Descripti-3n:
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 comely with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
Water Meter:
Fee S
Sewn Hookup: (City)
Fee S
Install PlumbinS Systems:
Fee $
Inoeall Sewap Disposal Systems:
Fee S
plicant
Si 4,17VL�
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InstallWater Hookup: (City)
Fee S
Install Water Supply Systems: (Well)
Fee $
SAC
FK S
Signat a of City O c:al
State Surtax:
Fee S
v �� U
Total Amount Paid to City Fee S --��-�-�
Code: WItite-File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt