HomeMy WebLinkAbout1981-07-28 Permit, Sewer Hook Up #6398City Permit N? 6398
Contractor Address �C
Owner &T Ki Address -EZ IJ-DACC
State License No.
City License No
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357 O
!date
Parcel No.
Section No. Lot Block Subdivision
Plat No.
Other Description:
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:
Fee S
Sewer Hookup. (City)
Fee S �e• �`C
Install Plumbing Systems:
Fee $
install Sewage Disposal Systems:
Fee $
Install Water Hookup: (City)
Fee S
Install Water Supply Systems: (Well)
Fee $
SAC
o c.
Fee S
State Surtax:
Fee S S C
Total Amount Paid to City .. ....
Fee S"Q�C�5101;
1
Sigf p liq
Si tna'ure of 'ty Official
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt