HomeMy WebLinkAbout1975-11-24 Permit, Sewage Disposal System #4279Village Permit N? 4 2 7 9*
Contractor �"Y1 C�/ Address
Owner !1bitult- i, A Address �-�� i1-� yu�t ► d`
State License No
Parcel No.
Section No
Plat No
Other Description:
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date
L ,t_ 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 shall include all additional specifications as listed bet w.
Water Meter:
Fee S
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S
Disposal Systems:
Fee S -
Signature of applicant
Install Sewage
Install Water Hookup:
Fee S
Install Water Supply Systems:
Fee S
Install Sewer Hookup:
Fee 5
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Signature of Village Official
State Surtax:
Fee S '5 /0
_
C '51)
Total Amount Paid to Village...........
Fee S