HomeMy WebLinkAbout1981-11-04 Permit, Water Well #6533City Permit N° 6533
Contractor
—_ � i rye- W Gl— I1r1 1 Address r T)A Q
Owner I ► wl ! 1, LONNO 2 Address
State License No.
Parcel No.
City License No.
GENERAL PERMIT
CITY OF OftONO
Crystal Bay, Minnesota
473-7357
Section No. Lot Block Subdivision
Plat No.
Other Descripiion:
Date 11-4 —
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 i.I additional specifications as listed
below.
sra ,z-T E D w /o PC rz 1 t-
"A8L 'FEE :2D- ac
Water Meter: Fee $
Sewer Hookup: (City) Fee S
Install Plumbing Systems: Fee S
Install Sewage Disposal Systems: Fee $ Signatur plicant
Install Water Hookup: (City) Fee S x
Install Water Supply Systems: (Well) Fee $
SAC Fee S '.5jAnilLyne o. "ty officia /
State Surtax: Fee $ 'r0
Total Amount Paid to City . .. . ... .. Fee $ 4'o • S O
Code: White -File Copy; Canary -Inspector': C,,.-v: Pink -Finance Copy; Gold -Applicant's Receipt