HomeMy WebLinkAbout1964-09-24 Permit, Water Supply Hookup #634Village Permit No 634
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Contractor to �.4_1'-" ^ _ Address___ _
Owner Cn7/ ��,,//
- - -- - Address.o� l LI "->� W' � — ---
State License No._ —_ —_ Village License No.__'_�__ _
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date�v�L 6 Y
i
Parcel 1\'0.
Section No / 7 J
Lot_7 — Block—i� _ Subdivision'111�I.re-.-,-c
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: Fee $-- -
Install
Repair sewage disposal systems: Fee_
Install
Repair
water supply systems: Fee
�Fee $--
�'b
Total amount paid to Village....... $7-
Signature of applicant
Signature of Village Official