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PERMIT <br />CITY OF ORONO <br />1335 Brown Rd. South • P.O. Box 66 <br />Crystal Bay. Minnesota 55323 <br />(612) 473-7357 <br />SITE ADDRESS: 416U FOREST LAKE DR <br />DESCRIPTION: <br />FEE SUMMARY: <br />PERMIT TYPE: <br />Permit Number: <br />Date Issued: <br />.:ewer & Water Permit Type WELL <br />Sewer & Water Work Type RESIDENCE <br />SEWER & WATER <br />000070 <br />08/19/87 <br />Base Fee $.00 WELL-------$QQ-LS1- <br />Surcharge ---------- Total Fee $30.50 <br />Subtotal $.SO <br />CONTRACTOR: -- Applicant -- PER: <br />STODOLA DON WELL CO 4'3:3$2111 AN ., J I M <br />162,06 HWY 7 4360 FOREST LAKE DR <br />MINNETONKA MN S5345 MOUND MN SS:364 <br />(612) 938-2111 <br />REMARKS: <br />114E U14DERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IfIPROVEMENTS <br />SPECIFIED AND AGREES TO 00 ALL WORK IN STRICT COMPLIkNCS WITH ALL CITY OF <br />L_ ORONO ORD I NANC:ES AND STATE OF M I NNE SOTA BUILDING CODE REQUIREMENTS. <br />I <br />APPLICANT PERMITEE SIGNATURE ISSUED SIGNATURE <br />