HomeMy WebLinkAbout1979-09-06 Permit, Water Well #5706City Permit N? 5706
Contractor STewe/U S l/V ELL Address PI APLE �,�� Aj
Owner t) �FAJAlt S K N ►'►'t t, IN Address - & (e .S 6 x S T.
State License No.
Parcel No.
City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnes.-Aa
473-7357 Date
Section No. Lot Z Block Subdivision EAW 4�n
Plat No,
Other Description: A/_ f /7 Z3 Nay S tn1 y S�
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 Meter:
Fee $ _—
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee $
Install Water Hookup: (City)
Fee S _
Install Water Supply Systems: (Well)
7 au
Fee S
Signature o 'cant /
I rVtQ/
SAC Fee $ Signature cat i I'll : iffy i /1 I
State Surtax: Fee S ti
Total Amount Paid to City ... .. . Fee $ G l� `
Code: White -File Cony; Canary -Inspector's Copy; Pink- inance Copy; Gold -Applicant's Receipt