HomeMy WebLinkAbout1967-05-19 Permit, Water Supply Hookup #1484State License No.
Parcel No.
Section No
Plat No_
Other Description:
Village Permit N2 1484
Villagc License No. _ __
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date
Lot 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 Villagc Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Install plumbing systems: Fee $
Install
Repair scwvage disposal systems: Fee $
Install
ter sup ly systems. Fee $--_—_
Repo'
-- Fee $_
Total amount paid to Villagc........
Si&: tatuure of applicant
d/z- 2Lk,
Signature of Village Officia