HomeMy WebLinkAbout1981-07-14 Permit, New Water Well #6371City Permit N8 6371
Contractor Ae�16ddressOwner OJ 4 Address 1161eli
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State License No.
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473•7357
Parcel No.
Section No. Lot Block Subdivision
Plat No.
Other Description:
Date / —J / 11 1_
I hereby agree that, in case a permit is granted, all work which shal! 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)
SAC
ee $
Fee $
Fee $
Fee S
Fee $
Fee S• �O
Fee $
State Surtax: Fee S
Total Amount Paid to City . .. . .... . Fee S,��
St icant
Signatu City Official
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt