HomeMy WebLinkAbout1973-12-03 Permit, Water Well #3839Village Permit 3339
Contractor �''��tud �� Address
Owner f t / �(1.% Lel - A All Address 'J k- : r
Sate Litxrtsc No Village License No
GENERAL PERMIT
VILLAGE OF ORORO
Crystal Bay, Minnesota
Dam /1.1 .� - ?j
Parcel No.
Section No Lot BlockSubdivisio++
Plat No
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: Fee S
Install Water Hookup: Fee S �nn
Install Water Supply Systems: Fee S '' //"
Install Sewer Hookup: Fee S
State Surtax: Fee S
Total Amount Paid to Village........... Fee S y�
Signature of applicant
Signature of Village Oficial