HomeMy WebLinkAbout1979-05-16 Permit, Water Well #5558City Permit Na 5558
Contractor sL-VtYt Y' d S 0XC Address 43 C0 21 Y r ' v'e
Owner 3 "^u Address � `� 3 J �LLI// Eey
State License No.
Parcel No.
City License No,
GENERAL PERMIT
GTI'Y OF ORONO
Crystal Bay, Minnesota
473-7357
Date
Section No. Lot I — Block Subdivision I�61'kJ
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 to 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" rat f licant
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well)
so
Fee S '^^
SAC
Fee S
Signature q, City ffic'
State Surtax:
Fee S
Total Amount Paid to City .........
_
Fee S 20 —
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt