HomeMy WebLinkAbout1981-07-01 Permit, Water Well #6363City Permit N? 6363
Contractor L_11 ad; _ . Address SS 3
Owner etA_ Address d 7gt4iv-c¢.�,-o
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
(Tl'Y OF OR,ONO
Crystal Bay, Minnesota
473.7357
Date 7 — /— P /
Block 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 comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
Water Meter:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S Signature a li t
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well)
Fee S
SAC
Fee S Signature of Cit official
State Surtax:
Fee $
Total Amount Paid to City .........
Fee S
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Cold-Applik•ant's Receipt