HomeMy WebLinkAbout1977-09-27 Permit, Septic System #4959City PermitN? 4959
Contractor Address /
Owner Address
State License No.
Parcel No.
Section No. _ Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357 �` n _
Date a�� Z-_C-
Block Subdivision
1 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 Hu kup: (City) Fee $
Install Plumbing,, stems: Fee $
Instsll Sewage Disposal Systems: Fee $ .w_ Signature of applican
I 1 /
Install Water Hookup: (City) Fee S -- --
Install Water Supply Systems: (Well) Fee S _
SAC Fee $ Signature (it City Official
O
State Surtax: Fee S
Total Amount Paid to City ... ... Yee S n
Code. White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt