HomeMy WebLinkAbout1974-09-06 Permit, Water Supply Hookup #4004-•*-4 T — 1^
i
4
n»
^5^
,1^
Contractor.ll/J
Village Permit 4004
Pii“n,
TutA^
• i.X«A.b. . _.
Owner.< tL-i^
State License No.
Addresi
Addresi f)0 a^<'i~(LJD
y^c#o
Village License No.
GENERAL PERMIT
"■^pp ' -T^4
^ VILLAGE OF ORONO
*1-"
C.Jtal Bay, Minnesota
Date.
Parcel No..
Section No,Lot Subdivision.
Plat No
Other Description:
;
■ *!
*. •■
r:.
I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be oaed, «»«!»
comply with the Village Code of Orono applicable thereto^ and shall include all additional specifications as lilted bdow.
____________________________________________________ __________________________________________________________________________________________
W
Water Meter;
Sewer Hookup:Fees
Ins^ Plumbing Systems:
liftstall Sewage Disposal Systems:
Fee S
Fee S
Install Water Hookup:Fee S
Install Water Supply Systems:Fee $ .n.^
Install Sewer Hewkup:Fees
State Surtax;Fees
Total Amount Paid to V'iUajie ............
'T'
, ... Fee S '
Signature of applicant
■S^Signature of Vilhige Official
/y)f fCc.
; i
,4#V
__