HomeMy WebLinkAbout1977-09-15 Permit, Water Well #4947City PermitN? 4947
Contractor4?1yt� Address
Owner Address 308"3
State License No. City License No. /OZ ((r'
Parcel No.
Section No. Lot
Plat No.
Other Description:
GENERAL PERMIT
CI' ' 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''listed
below.
Water Meter:
Fee $
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee $ S' to cant
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well)
Fee S_
SAC
Fee S Signature of City official
State Surtax:
Fee $
Total Amount Paid to City .......
'^e S .;2B S
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt