HomeMy WebLinkAbout1967-09-20 Permit, Water Supply Hookup #1633Village Permit N2 1633
Contractor r a 6 L--1 . Address
Owner �� 7 tf eu-t/'-�)�, Address �r .1 e01 /a L1 f�e
State License No _ Village License No._.
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date r
Parcel No.
Section No Plat No Lot—___ Bloch Subdivision
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Other Description:
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 Codc of Orono applicable thereto, and shall include all additional specifications as listed /below.
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12-6 —
Install plumbing systems:
Install
Repair sewage disposal systems:
Install
Repaiwater supply systems:
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Fee $------- —
Fee $
Foe $1f - 00
Total amount paid to Village........ $-___.._. -
Signature of applicant
Signature of Village Official