HomeMy WebLinkAbout1980-09-29 Permit, Septic Repair #6124City Permit N? 6124
Contractor _ Address —
Owner- �� '- _ Address > `� ���� �—k' —�
State License No
Parcel No,
Section No.
Plat No. _
Other Description:
City License No.
GENERAL PEF MIT
CITY OF ORONO
Crystal Bay, MinnesWa
473-7357
Dote
Lot Block Subdivision
I hereby agree that, in case a permit is granted, all work which shall be dote and all materials which shall be used,
shall comply with the City Code of Orono applicable tl.ereto, and shall include all additional specifications as listed
below.
•.1 .mil / �
Water Meter:
Fee $ _
Sewer Hookup: (City)
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
I-ce $
Install Water Hookup: (City)
Fee $
W S 1 S t (Well)
Fee S
�aature u( applica
Cc`_ ._
Install ater upp y ys ems.
Fee $ Signature of City Uffiria
SAC
State Surtax: Fee S
Total Amount Paid to City . ... .... Fee $_
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt