HomeMy WebLinkAbout1977-06-14 Permit, Water Well #4831City Permit Na 4831
Contractor �4� Address
Owner Address -
State License No. ----City ► icensc No. —
GENERAL PERMIT
CITY n1%.Y%P ORONA O
Crystal Bay, Minnesota
473-7357
Parcel No
Section No. Lot Block Subdivision
Plat No.
Other Description:
1�-le, •?i
Date___ WI— /41— 7
hereby agree that, in case a permit is granted, all -work which shall be done and all materials which shall be used,
shall 7omply with the City Code of Orono at; licable thereto, ant: shall include all additional specifications as listed
below.
Water Meter: Fee $
Sewer Hookup: (City) Fee $ _
install Plumbing Systems: Fee $
Insta.l Sewage Disposal Systems: Fee S _ applicant
Install Water Hookup (City) Fee S
Install Water Supply Systems. (Weil) Fee S _ ' � • O
SAC Fee $ Signat - of City O^ffic ,. �,
State Surtax: Fee $
Totsi Amount Paid to City ......... Fee $ z0 5-0
Code: Whit&File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt