HomeMy WebLinkAbout1975-05-01 Permit, Repair Septic System #4111Village Permit N° .. 4111
Contractor Address
Owner. Address— �
State License No. Village License N
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Parcel No
Section No Lot Block Sur .':vision
Plat No
Other Description:
Date
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:
Sewer Hookup:
Install Plumbing Sys ms:
Install Sewage Dit,
s
Install Water Hookup.
Install Water Supply SyNtems:
Fee S
Fee S
Fee S _
Fee S O D
Fee S
Fee S
[•%fall Sewer Hookup Fee S /+
State Surtax: Fee S l C%
Total Amount Paid to Village........... Fee S 4
Signature of applicant
Signature of Village Official