HomeMy WebLinkAbout1976 - 4508 - general permit 4 t`
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Village •Permit
N°4505
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Contractor / "iG%,�.: s [ Address -
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Owner
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
—y n '7 — 1
Date l ' ' ' '
Parcel No.
Section No
Lot Block Subdivision. 1 '
3 Plat No
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-A,. i Other Description:
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a 4 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 Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
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.}ete /7/ -7-2,- ,,IV,7‘1___/‘-e--_,, „ __--s.,-.-.;.,c
<. Water Meter: Fee S
tSewer Hookup: Fee S ..:;;P e e 6
>. �'. Install Plumbing Systems: Fee S
Signature of applicant ,
Install Sewage Disposal Systems: Fee S /
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Install Water Hookup: I: 1' - 6 ia.,i -
.S pzett,L'
t IInstall Water Supply Systems: Fee S
,i Fee S
Install Sewer Hookup: Signature of Village Official
50
State Surtax: Fee S• /
4.M. Zil. S�1 , ,/ C
Total Amount Paid to Village Fee S /