HomeMy WebLinkAbout1980-10-21 Permit, Water Well #6153City Permit N? 6153
Contractor
Address �— l
Owner Address
State License No.
Parcel No.
City License No.
GENERAL PERMIT
CITY OF OR,ONO
Crystal Bay, Minnesota
473.7357 /LO
Date !'
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 $
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee $
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well) Fee
Si a of applica
SAC Fee $ Sig t City Official
State Surtax: Fee $ . St�
Total Amount Paid to City ......... Fee S S-10 �f
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt