HomeMy WebLinkAbout1981-11-24 Permit, Water Well #6570City Permit N! 6570
Contractor Lt uT N N E(L W E (_C_ Address t AD'r l a Mtn
Owner M - N4wimr�2 Address / AQ5 E(-P"6y4004
State License No. 1. ifl 12S City License No.
GENERAL PERMIT
CPl'Y OF ORONO
Crystal Bay, Minnesota
473.7357
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.
water Meter:
Fee S
3ewer Hookup: (City)
Fee S
In Plumb stems:
Install � Sy
Fee S
lastall'Sawwp Dupoal Systems:
Few $ si/itture of applicant
Install Water Hookup: (City)
r% p'
Fee S T/r /L/ �!J /i.y
lama water Supply Systems: (well)
0
Fee S �•
SAC
Fee S 'ty official
State Surtax:
Fee $ .5-0
Total Amount Paid to City .........
Fee S ob• So
Code: wblte-File Copy; Canary -inspector's Copy; rink -Finance Copy; Gold-Apphcant's Receipt