HomeMy WebLinkAbout1979-05-30 Permit, SAC #5576City Permit N? 5576
Contractor Address
Owner Address
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357
Block Subdivision
Date ->
�_ ZZ,
I hereby agree that, in case a permit is granted, all work which shall ht- done and all materials which shall be used,
shaC •_o:�iply with the City Code of Orono applicable thereto, and shall include all additional specifications as listed
below.
Water Meter:
I-ee S
Sewer Hookup: (City)
Fec S
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee $
Install Water Hookup: (City)
Fee S
Install Water Suppry System%: IWelll
I-ee $
SAC
Fee S t
State Surtax
Fee S
Total Amount Paid to City . .. . ....
/
. Fee S
Sign: ur ity Official
Code: White -File Copy: Canary -In s,vctor's Copy. Pink -Finance Copy; Gold -Applicant's Receipt