HomeMy WebLinkAbout1981-09-15 Permit, Sewage Disposal System #6465City Permit N? 6465
Contractor Address /3 3 5z
Owner 61 Y' L Address
Ci
State License No.
P,.rcel No. _
—City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357
Section No. Lot Block Subdivision
Plat No.
Other Description:
Date �' 1,:5- — dr- 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 all additional specifications as !fisted
below.
Water Meter.
Sewer Hookup: (City)
Install Plumbing Systems:
InetaU Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Weil)
SAC
Fee $
Fee $
Fee $
Fee $ ja. n Signar of applicant
Fee f
Fee S
Fee S
State Surtax: Fee $ 1 J 6
Total Amount Paid to City ......... Fee S 9,U • Z U
Signature of City Official
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Code: Wadte-File Copy; Canary -inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt