HomeMy WebLinkAbout1969-06-18 Permit, Install Sewage Disposal System #2162Village Permit N o 2 1 6 2
Contractor /
Address �.
Owner ...
�`'t-rO Address
State License No
Section No
Other Description:
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Parcel No —
Lot Block-- Subdivisi
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 nhinibing systems: Fee S
Install �yL
sewage disposal systems: Fee $_
Repair
Install
Repair
water supply systems: Fee $
---- - -- Fee $ -A—d _
Total amount paid to Village....... $�
Signature of applicant
Signature of Village Official