HomeMy WebLinkAbout1981-09-08 Permit, Water Well #6452City Permit N? 6452
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Owner - _ Address_— Z O zV '-' 11�� V P
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
�fl Y OF ORONO
Crystal Bay, Minnesota
473-7357 �P.
Date — cT-' ` or-/
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 o!'Orono applicable thereto, and shall include all additional specifications as listed
below.
Water Meter:
Fee $
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee S _ Signature of applicant •�
Install Water Hookup: (City)
Fee S - (%
Install Water Supply Systems: (Well) Fee $ O 06
SAC Fee S Signature of rity o Ficial
State Surtax: Fee S r �n
Total Amount Paid to City . .. . .... . Fee $
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt