HomeMy WebLinkAbout09-01-1976 Permit, Water Well #4587Village Permit N? _ 4587
Contractor ------Addrcss-
Owncr_
State License No._
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Village License No _____________________________
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date _y' /
Section No.
Parcel No._
Plat No —
Block.Subdivision-
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 Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Water Meter:Fee S
Sewer Hookup:Fee $
Install Plumbing Systems:Fee S
Install Sewage Disposal Systems:Fees
Install Water Hookup:Fee S
Install Water Supply Systems:Fee S
Install Sewer Hookup:Fee S
State Surtax:Fee $
Total Amount Paid to Village ..........
Signature of applicant