HomeMy WebLinkAbout1973-11-06 Permit, Water Hookup #3813Village Permit T `� t 0
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Contractor Address
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Owner rt/ - �r Address / �; C u e �Q 4. C�e 41 1
State License No. Village License
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date
Parcel No._
Section No Lor Block Subdivision
Plat No
Other Description:
I hercb}' 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.
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Water Meter-
Sewer
eterSewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup.
Install Water Supply Systems
Install Sewer Hookup
State Surtax
Total Amo int Paid to Vdlagc
Fee S
Fee S
Fee S
Fee S _
Fee S
Fee S
Fee S
Fee S `'
i
Fee 3
Signature of applicant
Signature of Village Official