HomeMy WebLinkAbout1976-06-10 Permit, New Water Well #4454r"'
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Village Permit 4454
Contractor.C(J£^
Owner.J.dyi\ya£ i t
State License No..
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date.
Parcel No..
Section No.Lot Blodc Subdivisioa
Plat No.
Other Description:
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.
Water Meter:Fee $
Sewer Hookup:Fees
Install Plumbir.g Systems:Fee $
Install Sewage Disposal Systems:Fee $
Install Water Hookup:Fees
Install Water Supply Systems:Fee $
Install Sewer Hookup;Fee S
State Surtax;Fee S
Total Amount Paid to Village...................Fee S 2d,
Signature of applicant