HomeMy WebLinkAbout1964-09-16 Permit, Septic System #623Village Permit N2 623
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Owner 6 -In ------- Addressv,; , /�—1
State License No. ______ Village License No.�
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Parcel No4te''` G o
Section No. LoL_3-_Q_ Block-/-- Subdivision Y,'1��-,��"
Plat No.___
Other Description:
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
sewage disposal systems
Repair
Install
Repair water supply systems:
Fce $-- -
Fee $
Fee $-__
Fee $----
Signature of applicant
Signature of Villagc Official
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Total amount paid to Village....... $ !�-- e--