HomeMy WebLinkAbout1972-10-18 Permit, New Water Well #3362F
Village Permit
Con tractor ., �� �'t—� Address
Owner 4-f1 GUA Address Ycn,,t r� f -fl f
State License No. ___ Vilbge License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date Ir — / - %
Parccl 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 shall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Install plumbing systems: Fee
Install
scnjgc disix)sal systems: Fee $
Reluir
Install _
Hata Supply systrnrs: hcc $�_
Relmir
---- --- I JI ---_ Fee $
Total amount Tmid to Village....... S L -Z2- -.
Signature of applicant
Signature of Village Oficial
M