HomeMy WebLinkAbout1979-10-17 Permit, Septic System #5774City Permit Na 5774
Contractor
Address
�C
Owner
Address
30.s
State License No.
to
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
GTl'Y OF OftONO
Crystal Bay, Minnesota
473-7357
Block Subdivision
Date _ Z/4— 7 /
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
Suer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee $ s tra
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well) Fee $
Sf a of PPHCAA
SAC Fee S _ of City Official
State Surtax: Fee SO ~
Total Amount Paid to City ......... Fee S ` s�
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt