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HomeMy WebLinkAbout1981-05-22 Permit, Sewer Hook Up #6322City Permit ) © 632f, Contractor 6Ai L �lN S?ft5 _ Add.e:s L o"e, LA KE Owner 07AQ ZDv I r— _ Address J4 L �OR L C State License No. Parcel No. Section No. Lot Plat No. Other Description: _. City License No. GENERAL PERMIT CITY 01r 0110NO Crystal By , Minnesota 473.1357 j Date Block Subdivision I hereby agree that, in case a permit is granted, all work which shall be done. and all material, which shall be used, shall comply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed below. sAC_ Pd TS.- P. 3191 111617,6 Water Meter: Fee S Sewer Hookup: (City) 00 Fee S 20, Install Plumbing Systems: Fee $ Install Sewage Disposal Systems: Fee $ Install Water Hookup: (City) Fee $ Install Water Supply Systems: (Well) Fee S SAC Fee S State Surtax: h Fee $ 5 (.' Total Amount Paid to City . ... .... . Fee $ '20. So Signatutc of nplic i t Si matu • �,f City Ofti a1 Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt