HomeMy WebLinkAbout1970-12-21 Permit, New Water Well #2629Village Permit
Contractor /& F Address
Owner rt � �t,�Z—Ln re: 1 �"1 �E ��— Address. q7 l tLit tn
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
bate l :- ; I 7 ii
Parcel No.
Section No Lot Block-- Subdivisi
Plat No _
Other Description:
1 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 thcrrto, and shall include all additional specifications as listed below.
Install plumbing systems: Fcc $ Signature of applicant
Install
scw:rgc dispxnal systems: Fee $
Re'9jt`
Install .. !( 0,-.
water supply systems: Fee $
Repxrir
---- _– -- _ Fee _
Total anunmt pxrid to Village....... $
Signature of Village Official