HomeMy WebLinkAboutPermit, New Water Well #4058Village Permit
Contractor J�p [-t+A_ (�l �C IL Address- Alt,
Owner Address
State License No. Village License No
Parcel No.
Section No_
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Cn'Stal Bay, Minnesota
Lor Block Subdivision
Date
4'58
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 thereto, and shall include 211 additional spe6fic2tions as listed below,
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems
Install Water Ilookup:
Install Water Supply Systcros
Install Sewer Hookup
FCC S
Fee S
Fee S
Fee S
Fee S
Fee S r
Fee S
State Surtax.
Total Amount Paid to Village ......... Fee S
Signature of applicant
Signature of Village Official
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