HomeMy WebLinkAbout1974-11-27 Permit, Water Hookup #4204ContractoT.4.L,
Owner , 1 .
Vills9. Permit
Addren
1011,-
Address
State License No. Village License No
Parcel No.
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF OAQNO
Crystal Bay, Minnesota
Lot Block Subdivision
D2te.._&-- A'7- 7a
I hereby agree that, in case a permit is granted, 211
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
lasted below.
Water Meter:
Sewer Hookup.-
Install
ookup:
Install Plumbing Systems.-
Install
ystems:
Install Sewage Disposal Systems:
Install Water Hookup:
Install Water Supply Systems:
Install Sewer Hookup:
State Surtax :
Total Amount Paid to Village
17ce S .
Fve S
Fee S
Fee S
Fee S
Fee S summanow
Fee S
Fee S
Fee Szr
1
Signature of applicant
Signature of Village Official