HomeMy WebLinkAbout1970-08-05 Permit, Water Well #2495V'A@" ►ureal N! 2 l 9 S
CAMUCI r - s! l c t C` Mies_ _
Stift lAmon Ns---- NAW Liccme No -
GENERAL PERMIT
VILLAGE OF ORONO
Crvchl Par, %Ijnnm*a
Pace] No -
secNo LD Block _ Subdivision
Plat No —
Otha Damption :
1 baeby apes that, in ase a permit is granted, all work which shall be done and all matcriah wbwh shall be used, sWI
comply with the Village Code of Oros applicable thereto, and shall include all additional sperificatioos as listed below.
Install plumbing systems: Fee S --- Signature of applicant
Install
sewage disposal systems: Fee S --
Repair - - - -- ----
/lnstaD
lz=---eater supply systems: Fee S- —=rA:2
Repau Signature of Village 05ciel
-- _--- -. Fee S
-otal amount paid to Village....... $-_--- _—, �� j