HomeMy WebLinkAbout1978-08-28 Permit, Septic System #5293CityPermitN° 5293
Contractor SkL,4-Z11A v-Q9FVleic5: Address _ OVA 51-Z' A"
Owner 9E-� J c19c C� FA1 Address 3067 64fz-y/E lV
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
GTrY OF ORONO
Crystal Bay, Minnesota
473-7357
Date
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 !;sted
below.
Water Meter:
Fee S
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S _
Install Sewage Disposal Systems:
Fee S Z�
Install Water Hookup: (City)
Fee S _
Install Water Supply Systems: (Well) Fee S
re of appB � •-
I
SAC Fee $ Signature `City O[ I
1�
State Surtax: Fee S
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Total Amount Paid to City ... . . .... Fee S 20 —Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt