HomeMy WebLinkAbout1980-11-14 Permit, Septic System #6193City Permit N? 6193
Contractor �.1/ 7XX�1/i�� Address
Owner Address O
State License No. City License No.
GENERAL PERMIT
CITY OF ORONO
Crystal Bay, Minnesota
473.7357
Parcel No.
Section No. Lot Block Subdivision
Plat No.
Other Description:
Date A,
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 S _..
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee $
Install Water Hookup: (City)
Fee $
Install Water Supply Systems: (Well)
Fee S
Signature of pplica t i
SAC Fee $ _ Signa City Official C�✓ LJ
State Surtax: Fee $
Total Amount Paid to City ... ..... . Fee $ �C • s0 '
Code: White -File Copy; Canary -Inspector's Copy; Pink -Finance Copy; Gold -Applicant's Receipt