HomeMy WebLinkAbout1973-11-12 Permit, Water Hookup #3817Village Permit - -39 17
Contractor \ ( Address.
Owner :4 t >L/ ti C Address /9r �s+ Ldi
Wf1Y%
State License No
Parcel No.
Section No
Plat No
Other Description:
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Low Block Subdivision
Date / /— 12—'— 7
1 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 311 additional specifications as listed below.
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup:
Install Water Supply Systems:
Fes. S
�y
Fee S
Fee S
Fee S
Fee S ,1(r�
Fee S
Install Sewer Hookup: Fee S
State Surtax: Fee S i Jn
Total Amount Paid to Village........... Fee S
Signature of applicant
Signature of Village Official