HomeMy WebLinkAbout1981-08-27 Permit, SAC #6437Contractor
Address
City Permit N0 6437
Owner [1D Vy—� C- N I " G:- L L Address f 01 I& IE��T ��t'NOVE _rY
State License No.
Parcel No.
Section No.
Plat No. _
Other Description:
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357 'I 7 —S7
Date i-
Lot 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 of Orono applicable thereto, and shall include all additional specifications as listed
below.
Water Meter:
Fee $
Sewer Hookup: (City)
Fee $ _
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee S
Signature of applicant
Install Water Hookup: (City)
Fee $
V�-
Install Water Supply Systems: (Well)
SAC
Fee $ _
Fee $
Se fficiaY
State Surtax:
Fee $
Total Amount Paid to City .........
vo
Fee $ 4 2 s.
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt