HomeMy WebLinkAbout1967-10-13 Permit, Water Supply Hookup #1652Village Permit No 1652
Contractor /,(1'.tJ Address
Owncr 6. C e— :Address �i� zi
State License No. -._ Village Licensc No.
GENERAL PERMIT
VILLAGF :�F ORONO
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Date - — / �5 " � —7
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: FCC $
Install
Repair sewage disposal systems: Fee $
Install
to skip)]) s}stcros: Fec $ _
Repai
—�- C� �►- - _ Fee �v
Signaturc of applicant
Signature of Village U/ficial
Total amount paid to Village........ S