HomeMy WebLinkAbout1978-11-05 Permit, Septic System #5437City Permit N? 5437
Contractor .SNLL / VAAJ 5;� Vic E e Address /may /0 %
Owner&&J,.Z,2 Address � Z'
State License No.
Parcel No.
City License No,
GENER<111L PERMIT
CPl'Y OF ORONO
Crystal Bay, Minnesota
473-7357
Section No. Lot Block Subdivision
Plat No,
Other Description:
Date lyl::� /7
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 Mater. Fee S _
Sewer Hookup: (City) Fee S _
Install Plumbing Systems: Fee S
ao .�
Install Sewage Disposal Systems: Fee S tgnat applic t
i
Install Water Hookup: (City) Fee S
Install Water Supply Systems: (Well) Fee S
SAC Fee $ Signature o[ City ficial
State Surtax: Fee S
Total Amount Paid to City ......... Fee S
Code: White -Fib Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt