HomeMy WebLinkAbout1976-04-19 Permit, Water Well #4367Village Permit N° 4367
Contractor _=��+� Addrec�
Owner. Address
State License No. Village License N
GENERAL PERMIT
VILLAGE OF ORONO
Cn'stal Bay, Minnesota </
Parcel No.
Section No Lot Bloc Subdivision
Plat No
Other Description:
I hereby agree that, in case a permit is granted, all work which shall be done and 211 materials which shall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include 211 additional specifications as listed below.
Water Meter: Fee S
Sewer Hookup: Fee S
Install Plumbing SystL.ns: Fee S
Install Sewage Disposal Systems: Fee S Signature of applicant
Install Water Hookup: Fee S
Install Water Supply Systems: Fee S
Install Sewer Hookup: Fre 5 _
Signature of Vibe offidW
State Surtax: Fee S 5-0 _
Total Amount Paid to Village.... Fees