HomeMy WebLinkAbout1969-06-24 Permit, Install Water Supply System #2165Village Permit N o 2165
Contractor_ C� C' C �{ Address —Ay 4 Itl, j } e tr. J
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Owner 41f/G�.4' Address n u Ci r
State License No
Parcel No
Section No
Plat No
Other Description:
Village License N
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot_ Block_ Subdivision
Date
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
tsI n's'ta
watcr supply systems:
Repair
Fee $ _
Fee $
Fee $
Fee $--
Total amount paid to Village....... $—
Signature of applicant
Signature of Village OTcial