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HomeMy WebLinkAbout1975-01-10 Permit, Sewer Hookup #4082■h- Viilage Parmif N? .. 4082 rnnHarfrn r ^ 11 “T ^J^5 “* W g Address- Owner. State License No.. Addr««_ i O i ^ l>^l I RJl, Village License No________________________ GENERAL PERMIT VILLAGE OF ORONO Crystal Bay, Minnesota Date __L Section No. Parcel No.. Plat No- Block.Subdivision. 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. oo ^ i/As p ^ r u j ^/ 4y ^uju « y Water Meter:Fees Sewer Hookup:Fees it) Install Plumbing Systems:Fees Install Sewage Disposal Systems:Fees Signature of applicant Install Water Hookup:Fees cUi Install Water Supply Systems:Fees Install Sewer Hookup:Fees w Signature of Village Official .•MB I State Surtax:Fee S , 6 ^ Total Amount Paid to Village ............___Fees / S' '