HomeMy WebLinkAbout1975-10-21 Permit, Sewer Hookup #4233r- -
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Villag« Permit N? ^ 4233
Contactor.I-Address.
Ownei ___^Address.■^«/g P\A I i PJ~
State License No.Vilhge License No.
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GENERAL PERMIT
VILLAOZ OF OBOHO
Crystal Bay, Minnesota
5|.Date.
'section No.
Parcel No.
Pbt No-
Subdivision.
Other Description:
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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 bdow.
Water Meter:Fee &
Sewer Hookup:.0 i
Install Plumbing Systems:Fee S
Install Sewage Disposal Systems:Fees
Install Water Hookup-Fees
Install Water Supply Systems:Fees
Install Sesrar Hookup:Fees
Sttte Surtax:F«I .SO
Total Amount Paid to Village...............Fee S AO . c0
Signature of applicant
Signature of Village Officia]
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