HomeMy WebLinkAbout1977-10-03 Permit, Septic System #4961City Permit N? _ 4961
Contractor dress100,
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Owner Address__34�-__K�'
State License No. City License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
GENERAL PERMIT
GTrY OF ORONO
Crystal Bay, Minnesota
473-7357 __ _ _ 7
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 $ �D • o
Install Water Hookup: (City)
Fee S
Install Water Supply Systems: (Well)
Fee $
SAC
Fee S
State Surtax:
Fee $ . _57c,
Total Amount Paid to City .........
Fee $ (:) , J1
Sig nsf appli nt
�� $
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Code: White -File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt