HomeMy WebLinkAbout1968-08-22 Permit, Water Supply Hookup #1920Village Permit N" 1920
Contractor . --e- — �, ��� Addres
Owner �J L=��. ,� Addres e;7-4;.,
State License No Village License N
GENERAL PERMIT
"ILLAGE OF ORONO
Crystal Bay, Minnesota
Date
Parcel No.
Section No Lot Block Subdivision— _
Plat No
Other Description:
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.
v
e_
Install plumbing systems: Fee $—
y—
s"age disposal systems: Fee $
Repair
Install
water supply systems: Fee $ _
Repair
-,44114 Fee $-11 Z).
Total amount paid to Village........ $�
Signature of appliea/nt) '
lam/
Signature of Village Official