HomeMy WebLinkAbout1965-12-04 Permit, New Water Well #1017Village Permit No 1017
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Contractor�G,l} �► �d x Address 479 S-Gc./C 1,
Owner /!
Address
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
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Section No Plat Parcel l No.Lot — Block_._ Subdivision
Other Description:
Dat . 19'(- /
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 shall include all additional specifications as listed below.
Install plumbing systems
Install
sewage disposal systems:
Repair
Install
water supply systems:
Repair
Nw i5tiL9_
Fee $ _ Signature of applicant
Fee $
Fec $ _
["CC $ �� _ Signature of Village Official
Total amount paid to Village....... $fir ,"�_