HomeMy WebLinkAbout1979-07-24 Permit, Septic System #5646City Permit N? 5646
Contractor Out wvze� go -ear Address �i�NCr
&X.
Owner AERRS/ 44LhRt0_+4- Address 0390 Fox ST.
State License No.
Parcel No.
Section No. Lot
Plat No.
Other Description:
City ? icense No.
GENERAL PERMIT
CTI'Y OF ORONO
Crystal Bay, Minnesota
473.7357
Date
Block Subdivision
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.
♦ ,SZ � �
Water Meter:
Fee $ _
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
ep
Fee S Signature of a icant
Install Water Hookup: (City)
Fee S —%
Install Water Supply Systems: ;Well)
l cc $
SAC Fee $ i Signatuw of city
Official
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