HomeMy WebLinkAbout1977-4962 - general permit City Permit?�a _ 4362
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Contractor i�� • :��dress �
Owner , 1� Address �_
State License No. City License No.
GENERAL PERNIIT
� C�IrI'Y OF �RON4
Crystal Bay, biinnesota
473•7357 A, 3 _ ?
Date � �
Parcel Na
Section No. I.ot Block Subdivision _
Plat No.
Other Description:
I hereby agree that, in case a permit is granted, all work which shall be done and all m;�terials which shall be used,
shall comply with the City Code of Orono applicable thereto, and shall include all additional specif:cations as listed
below.
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Wawr Meur: Fec S / ''=
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Sewer Hookup:(City) Fee S - (.6�./P (�v /q�� /�,00 k. cl�� �4'►��p �� (N�41ZT1'C. ,�^
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�''Inttall PlumbIt�g Syauma: Fec S �Y���`'�^' :
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InstaII Seaaga Dispoaal Systema: Fee S Signatu��applican ,/y%/J /� �
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�itall Water Hookup:(City) Fee S s� �� �� �'�� � �
Iar'.ail Wa:e�Supply Systems:(WeU) Fce S
SAC Fee 3 Signature o City Offic' '
State Surtax: Fee S .50 �
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Total Amouat Pdd to City . . . . . . . . . Fee S f.5��V i:;�y '
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Code:WhitaFile Copy;Cmary-Inspector's Copy;Pink-Finance Copy;Gold:ApplicanY�Ccipt �,:
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