HomeMy WebLinkAbout1969-04-10 Permit, Water Well #2081r
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State Lksme No.
r
Villi|e License No.
GENERAL PERMIT
VILLAGE OF OBOMO
Ciystal Bay, Mignoots
Seclioa No.
Fined No..
Pbt No —
Block.Subdivision
Other DtKxi|itioii:
I hanbjr agree that, in ease a permit is granted, all work wUdi shall be done and all materials which shall be used, shall
comyljr widi the Village Code of Otono applicable thereto, and shall include all additional specifications as litled bdow.
4
Install phimbmg r'tcnu:Fees.Signature of applicant
InstaU
Hicnair
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sewage disposal ssstcins: Fee $.
,*!:^ter supply ssstcins: Fee %
Repair
Fee %.
^ Total amount paid to Village ............5-4^ 0 I
Signature of V'illagc Qficial
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