HomeMy WebLinkAbout1972-10-04 Permit, Water Supply Hookup #3333Village Permit 3333
1
Contractor { Address ` ���--
Owner °'x ate- U �)(? Address
State License No. Village License No
GENERAL PERMIT
VILLAGE 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.
Install plumbing systems:
Install
sewage disposal systems
Repair
Install Repair
water s�+���� J- 44,v-
Fee $
Fee $
Fee $ C1 00
— Fee L
Total amount paid to Village. ..... $
Signature of applicant
Signature of Village Official