HomeMy WebLinkAbout1967-09-20 Permit, Water Hookup #1634Village Permit N2 1634
Contractor �� r Address
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Owner— Ll/ _ :Address / r�/'
State License No.—_____-___ ..______ _ Village License No. -----
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Parcel No.
Section No Lot__
Plat No
Other Description:
Datc_�^�-�
l7
Block---- Subdivision ---
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 shali include all additional specifications as listed below.
Install plunibirig systems: Fee $
Install
Repair savage disposal systems: Fee $
Install
Re rwater su ply systems: Fee $ _
r , Fee $J'r-0
"Dotal amount paid to \ illage........ $
Signature of applicant
Signature of s. illagc Bial