HomeMy WebLinkAbout1973-07-30 Permit, Water Hookup #3721■■ W'l
■
■ :, ,V-: •^ .Village Permit 3T31 4
■* 4^
Contractor.Address.
Owner.aa Address.M4!lA^f)fual
State License No..Village License No.
GENERAL PERMIT
VILLAGE OF OROKO
Crystal Bay, Minnesota
Date.
Parcel No..
Section No.Lot Block 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 speciheations as listed bdow.
Water Meter:Fees
Sewer Hookup:Fee S
Install Plumbing Systems:Fee S
Install Sewage Disposal Systems;Fee S
In'iall Water Hookup:Fee S
Install Water Supply Systems:Fees
Install Sewer Hookup;Fee S
State Surtax;Fee $
Totil Amount Paid to Village. ..............Fee $
Fee S If)' O ^
/O. C0
:x<
Signature of applicant
Signature of Village Official
'/hilfr