HomeMy WebLinkAbout1979-09-10 Permit, Septic Repair #5710City Permit IN? 5710
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t Owner CAI J f Address -5 a!q
State License No. City License No.
GENERAL PERMIT
CITY OF ORONO
Parcel No.
Section No. Lot
Plat No.
Other Description:
Crystal Bay, Minnesota
473-7357
Date— C? -.
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,
stall comply with the City Code of Orono applicable thereto, and shall include all additional specification: as listed
below.
Water Meter: Fee S
Sewer Hookup: (City) Fee f
Install Plumbing Systems: Fee f —
G�
Install Sewage Disposal Systems:
Fee $
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Sign tou of as liclican`t
Install Water Hookup: (City)
Fee f
h stall Water Supply Systems: (Well)
Fec f
_
SAC
Pee f
Signature of C' al
State Surtax:
Fee f
U
Total Amount Paid to City . ... ...
. Fee $
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt