HomeMy WebLinkAbout1976-08-05 Permit, Septic Repair #4535Village Permit N° _ 4535
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State License No. Village License No
Parcel No.
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Blodc Subdivision
Date " '- 7,6 _
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.
Water [deter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup:
Install Water Supply Systems:
Install Sewer Hookup:
State Surtax:
Fee S
Fee S C>1 00
Fee S
Fee S
Fee S
Signature of applicant
Fee S
Fee S
Fee S . sp
Total Amount Paid to Village.......... Fee S `15—U
Signature of Village Official