HomeMy WebLinkAbout1975-10-03 Permit, SAC #4197Village Permit N° 4197
Contractor Address
Owner Address 4f 2=E J). /" o
Statc Licensc No. Village License No
Parcel No.
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivisio*+
Date Lk*7 - 3 -- -7 S'
I hereby agree that, in rase 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.
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup:
Fee S
Fee S
Fee S
Fee S
Fee S
Install Water Supply Systems: Fee S
Install Sewer Hookup: Fee S
State Surtax: Fee S
Total Amount Paid to Village........... Fee S
Signature of applicant
Signature of Village Official
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