HomeMy WebLinkAbout1981-10-22 Permit, Sewer Hook Up #6515City Permit N? 6 515
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Owner jSt UL V7o )4 Address/119.5— (A) �ER_ND4 Lc
State License No,
Parcel No.
City License No,
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-735'i d
Date
Section No. Lot Block Subdivision
Plat No.
Other Description:
1 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:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
Fee E
Fee S 'Zo G O
Fee $ _
Fee $
Fee f
Fee $
SAC I ee S
State Surtax: Fee $ $�O
Total Amount Paid to City ......... Fee t
Sigrtatux of app .•t�
Signal ure 01City O isI
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt