HomeMy WebLinkAbout1967-09-27 Permit, Water Supply Hookup #1639Village Permit No 1639
Contractor 1� Address-
Owner----
ddress Owner_—_ k�4? C�? �' n/ a ✓ Address��o
State Licensc No
Section No
Other Description:
Village Liccnse No. --
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Ba)', Minnesota
Date-
Parcel No.
Lot— Block Subdivision---------
Plat
ubdivision — ---Plat No
I hereby agree that, in case a permit is granted, all work which shall be clone 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: Fee
Install
scwage dislx)sal systems: Fee
Repair
Install
water supply systems: l'ec �—
�:VFee
Total amount livid to s IIIaKL . ...... S___-• _
Siguaturc of applicant.
Signature of ♦Village ial
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