HomeMy WebLinkAbout1978-12-05 Permit, Water Well #5438City Permit N? 5438
Contractor
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Address
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Owner
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State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
—City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473 ?357
Date 12 _ 78
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.
or S-r-pm- O e2 z_ a - T'a G, r Y
Water Meter:
Fee S
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee $
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well)
Fee S
SAC
Fee S
State Surtax:
Fee S
Sigma urc of app ' an
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V
Signature of City fficial r
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Total Amount Paid to Citv ... ..... Fee $ -�_ C) "—
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt