HomeMy WebLinkAbout1973-04-24 Permit, Install Water Supply #3611Village Permit 3 611
Contractor lV L_t ,(� Address
Owner �LI�L l r Y1 Address
State License No
Parcel No._
Section No
Plat No
Oilier Description:
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date
I hcrcb}, 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.
Water Meter:
Fee S
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Instali Water Hookup:
Fe: S
Install Water Supply Systems:
Fee SInstall
SewerSewer Hookup:
Fee S
State Surtax:
Fee S
Total Amount Paid ti N,illagr.........
. Fee 1�`�_''
Signature of applicant
Signatute of Village Official