HomeMy WebLinkAbout1977-03-08 Permit, Septic System #4760City Permit IN? 4760
Contractor_ Address
Owner ���a�/ C�z Address 30 5' yi
00,
State License No. City License No.
GENERAL PERMIT
GTI'Y OF ORONO
Crystal Bay, Minnesota
473-7357
Date
Parcel No.
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.
4-
Water Meter:
Fee S
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee S ��i oo
Install Sewage Disposal Systems:
Fee $ 4� �� Be Signature o ca `
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well) Fee S
SAC Fee $ Signature of City Official
State Surtax: Fee $
Total Amount Paid to City ......... Fee $ 6�. 00
Code: White -File Copy; Ca^ary-Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt