HomeMy WebLinkAbout1964-12-21 Permit, Water Well Repair #722Village Permit No ' 722
Owner! -�x—+� Addresser 'S
State License No Village License No
S.O
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minncsout
Date
�, Parcel Lot_ 0 Block-Lf—Subdivisio
00
Section No plat Noo
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.
Install plumbing systcrus:
Install
sewage disposal systems:
Repair
water supply systems:
Repair
rce $
rce $
c3 -ti
Fee $6
rce $
� D -U
Total amount paid to Village....... $�
Signature of applicant
Signature of Village Official
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