HomeMy WebLinkAbout1978-07-11 Permit, Water Well #5241r
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City Permit^®5241
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Owner /^y/!)AJ___________________
Address 7 h^Kfi^
. Address 3 ^2.^SXD fjp y______________
State License No..City License No..
GENERAL PERMIT
cm OF ORONO
Crystal Bay, Minnesota
473-7357
Date.V-11-73
Parcel No---------
Section No____________Lot.Block.Subdivision.
Plat No.
Other Description:
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.
OF i^usrrse^ cLivy^
Water Meter:
Sewer Hookup: (City)
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup: (City)
Install Water Supply Systems: (Well)
Fees
Fees
Fees
Fees
Fees
i
Signature of applicant
Fees
SAC
State Surtax;
Total Amount Paid to City
Fees
Fees
Signature of City Ofn^l
..........Fee S 2^0
Code: White-File Copy; Canary-Inspector’s Copy; Pink-Finance Copy; Gold-Applicant’s Receipt
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