HomeMy WebLinkAbout1978-06-07 Permit, Water Well #5188City PermitN? 5188
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State License No.
Parcel No.
City License No.
GENERAL PERMIT
LTl'Y OF ORONO
Crystal Bay, Minnesota
473.7357
Section No. Lot Block Subdivision
Plat No.
Other Descriptien:
Date 6,-?-7A
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
install Water Hookup: (City) Fee S
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Install Water Supply Systems: (Well) Fee S a�0 —��
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SAC Fee $ Signature of City Wicia
State Surtax: Fee S
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Total Amount Paid to City ......... Fee $
Code: White -File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt