HomeMy WebLinkAbout1965-12-017 Permit, Install Septic System #1023i'-
Contractor
Village Permit N?
O S< ''
1023
Address
Owner_____________'j^c.L^tx Address
State License No.._ — ______________ Village ISccnse^O/.^5?c c^€x> "/^ej
il G-x/'GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
.ki-‘I ^
Hate.
Section No.
Pi^
Parcel No.^^V^^O / ^7 m i /^ Lot. /> .-X Block- ■. ^
Plat
Subdivision.
Other Description:1
7
* \
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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Install plumbing bySfcins;Fee 1 Signature of applicant
InstaH
Repair
sewage disposal systems: I cc
70
Install ,water supply systemv:
Repair
! t^e $.
iL,I eg $Signature of V illage Official
i otal amount paid to V'illagc ...........$_/...jg:.-.