HomeMy WebLinkAbout1968-77-07 Permit, Water Well #2005• Village Permil Ng 2005
Contractor .,l t ���! A01 hJ l,(t[ L,., Address 1(42 N di tc
Owner , Address
State License No _ Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Parcel No.
Section No Lot Block__ Subdivision
Plat No
Other Description:
I hereby agree that, in rase a permit is granted, all work which shall be done and all materials which sliall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Install plumbing systems: Fa $ Signature of applicant
Install sewage disposal systems
Ltmusb9sapply systems:
Repair
Fcc —
Fee s -Ir, - 12-9
Fee $
Total amount paid to Village........ 5JQ.- 0 -f -
Signature of Village Official