HomeMy WebLinkAbout11-17 Permit, Repair Septic System #976Contra
Owner
_ -
L_--. Address__
Village Permit No 976
State License No. —__ __ Village Liccnu\o.�4�_�_�_
CIA -, /i � (� 'V V -
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
-V /'I ---.
DatcA*z4f r W
No-6-444)Section No... Parcel NoLoBlock_______ Subdivision
Plat No.--
Other
o. _Other Description: 6 q
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.
Install plumbing systems:
s 'age �posal systems:
Repair
I install
water supply systems:
Repair
Fee $--
14 _
14"cc $ __
Fee $_--- - - --_ -
Signature of applicant
Signature of \'Illage Official
1'utal amomit paid to Village