HomeMy WebLinkAbout1969-04-25 Permit, Repair Water Well #2096Contractor_-_s,.e%�Address .
Owner__ L. 1 ;
Village Permit No
2096
State License No.__ . _ _ Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Parcel No.
Section No. Lo.. _.___ _. Block._ Subdivitiiun_ _
Plat No
Other Description:
I hereby agrec that, in case a permit is granted, all work which shall he dome and all inateriah which shall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Install pluml,ntg systcrns: Fee 9, _ _--_—_---
Install
Repair sewage disposal systems: Fee
1 nstall
water supply svitems: 1"ee _
i 11 ePair
E"'Nt___.
'Total amount Iwul to \ iilage.... $--
Siglwturc of applicant
signature of \ illagc Of6cwl