HomeMy WebLinkAbout1979-06-25 Permit, Septic System Repair #5617City Permit N 8 5617
Contractor Wm/Ki e &es , Address :5eww e,, le-9ielr
Owner R ax r .µ C . )Rae -LE Y Address gOS u) �E.eNm4�_ -
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GEN'k.RAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357 _ZS_ —r79
Date
Block Subdivision
I hereby agree that, in case a permit is granted, all work which shall be done and all materials which sha!1 be used,
shall comply with the City Code of Orono applicable thereto, and shall include all additional specific.tlons as listed
below.
Water Meter:
Fee S
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee $
Install Water Hookup: (City)
Fee S
Install Water Supply Systems: (Well)
Fee $
Signature �f_ppl�c t
� 'Z�
SAC Fee $ Signature cit tt% Oflu al
S�
State Surtax: Fee $ _
S�
Total Amount Paid to City ... . .... . Fee $
Code: White -File Copy; Canary -Inspector's Copy; Pink-Fir.ance Cory; Cold -Applicant's Receipt