HomeMy WebLinkAbout1976-05-07 Permit, New Water Well #4400Village Permit - 4400
Conriarror Address.
Owner.Address 4^/ ^
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State License No..Village License No.>»i
GENERAL PERMIT
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VILLAGE OF ORONO
Crystal Bay, Minnesota
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Date.X- 7-
Parcel No..
Section No,Lot Block.Subdivisioa
Plat No.
Other Description:
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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 below.
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Water Meter:Fee S
Sewer Hookup:Fee $
Install Plumbing Systems:Fee S
Install Sewage Disposal Systems:Fee $
Install Water Hookup:Fee $
Install Water Supply Systems:Fee S ^ i
Install Sewer Hookup:Fee S
State Surtax:Fee S /5^
Total Amount Paid to Village............:j.c, iv
Signature of applicant
Signature of Village Official