HomeMy WebLinkAbout1976-08-20 Permit, Water Meter #4557Village Permit N° 4 5 5 7
Contractor_— �'- tcs'2 Address
Owner �u �I1 z a ! ,4 Address-3 44f
Statc Licensc No. Village License No
Parcel No.
Section No
Plat No
Other Description:
GENERAL PERMIT
TILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date
I hereby agree that, in case a permit is granted, all work which shall 'oc 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.
7--7
Water Meter: Fee S e7d
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Signature of applicant
/
Install Water Hookup:
Fee S 1.5•
Install Water Supply Systems:
Fee S
Install Sewer Hookup.
Fee S
Signature of Village Official
State Surtax:
Fee S S C
'
Total Amount Paid to Village...........
Fee S
' _'