HomeMy WebLinkAbout1977-08-19 Permit, Septic System #4913City PermitN? 4913
Contractor Address
i e
Owner Address
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
CP!'Y OF ORONO
Crystal Bay, Minnesota
473-7357 7 7
Date J
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.
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f 9c44 � - sl/
Water Meter:
Fec $
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fec $ i ?i.PPl' a
Install Water Hookup: (City)
Fee S
Install Water Supply Systt-ms: (Well)
Fee $
SAC
Fee $ Signature of City Official A
State Surtax:
O—�
Fee S
Total Amount Paid to City ......... Fee S g,
O - G
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt