HomeMy WebLinkAbout1977-09-15 Permit, Septic System #4943I
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City Permit N9 4943
Contractor
^ Owner KeA/ ______________
Address
, Address o29c3fr fo yC. ST"._________
State License No.City License No..
GENERAL PERMIT
OTY OF ORONO
Crystal Bay, Minnesota
473-7357
Date.7-/5--77
Parcel No_____
Section No____________Lot.Block.Subdivision.
Plat No.
Other Description:
Water Meter:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
InstaU Water Hookup: (City)
Install Water Supply Systems: (Well)
SAC
State Surtax:
Fees
Fees
Fees
Fee S >
Fees______
Fees______
Fees______
QCJ
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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.
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Signati^ cf applicam jj J
Fee S , S<^
ToUl Amount Paid to aty....................Fee S
Code: White-File Copy; Canary-Inspector’s Copy; Pink-Finance Copy; Gold-Applicant’s Receipt
Signature of City OffidaK ^
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