HomeMy WebLinkAbout1972-09-27 Permit, Septic System #3317Village Perrr
Contractor -AzAZ — ] Address
LA
� 1 � A J ��, r / /i
Owner—_ Address ��L� h-
State License No. Village License No
Parcel No
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot— BlockC 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 dispesel systesus
Repair
Install
Fee
Fee$ %Q•y�
Signature of applicant
water supply systems: Fee $
Repair r_ Signature of Village Official
Fee $ . �h
k
r o c �A
Total amount paid to Village....... $� / Y14