HomeMy WebLinkAbout1981-04-16 Permit, Septic System #6302City Permit _N? 6302
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Contractor Wt Ate.. Address S'DCC k�r Q
Owner , Address 30 R6
State License No. City License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
GENERAL PERMIT
CITY OF 0110NO
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 listed
below.
Water Meter: Fee S
Sewer Hookup: (City) Fee $
Install Plumbing Systems: Fee S
Install Sewage Disposal Systems: Fee $ Sig re of a lican /
Install Water Hookup: (City) Fee S T_
Install Water Supply Systems: (Well) Fee $
SAC Fee $ Signature f (' Official
State Surtax: Fee $
Total Amount Paid to City ......... Fee S , SD
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy: Gold -Applicant's Receipt