HomeMy WebLinkAbout1976-08-23 Permit, Water Supply #4563Village Permit N° 4563
Contractor ? �� �{ r L .r !� < < ^ Address
Owner zYa, J.'`Address
State License No
Parcel No
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date ''� 2c,
Section No Lot Block Subdivision
Plat No
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.
Water Meter:
Fee S
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Install Water Hookup:
Fee S
Install Water Supply Systems:
Fee S
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Install Sewer Hookup:
Fee S
State Surtax:
Fee S
St
Total Amount Paid to Village...........
Fee S
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Signature of applicant
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Signature of Villa QfFic' I
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