HomeMy WebLinkAbout1969-12-04 Permit, Water Hookup #2363VNIage ParmH NS 2363
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Contractor-Address-
Ownet.'7?mhorr\ 6 5 \Jo /I Jtr'j /y^^/
Slate License No.
Address.
Vilh^ License No
GENERAL PERMIT
VILLAOE OF ORONO
Crystal Bay, Minnesota
Parcel No.
Section No-Lot.
Pht No.
OAer Description:
Subdivision
I 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 all additional specifications as listed bdow.
CJ.t
Install plumbing systerm:
Install
Fee 1.Signature of applicant
sewage disposal systems: Fee $.
Repair
Install
water supply systerm: Fee S-
P--Fc=$:^
Total amount paid to Village..........$------
Sigiuture of Village Official