HomeMy WebLinkAbout1980-09-23 Permit, Water Well #6119City Permit IN? 6119
Contractor Address
Owner L
Address
State License No.
Parcel No.
Section No.
Plat No. _
Other Description:
_City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473-7357 9�3 (0
Date d'
Lot 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 lis:ed
below.
, .,e
i V 6, --- --
Water Meter:
Fee S
Sewer Hookup: (City)
Fee $
Install Plumbing Systems:
Fee $
Install Sewage Disposal Systems:
Fee S
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well)
Fee S �.
SAC
Fee S
State Surtax:
Fee $
Si i't 'I Apli.:ant
Signs (City Official
total Amount Paid to City ......... Fee S rT O, S'C
Code: White -Fib Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt