HomeMy WebLinkAbout1981-10-13 Permit, Water Well #6506City Permit Na 6506
Contractor L Address
Owner Address
State License No. City License No.
Parcel No
Section No.
Plat No. _
Other Description:
GENERAL PERMIT
CPl'Y OF ORONO
Crystal Bay, Minnesota
473.7357 Date
Lot 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:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
Fee $
Fee S
Fee S
Fee S
Fee S a
c
Fee S
SAC Fee $
5�
State Surtax: Fee $
Total Amount Paid to City . ... .... . Fee S
Code: WhitrFile Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold-Alit' ppcans 1..,.....r.
Sigr:ature of applicant