HomeMy WebLinkAbout1976-05-05 Permit, Water Supply #4394Villago Ptrmif „ 4394
Contractor
Owner -------------------------------
Address.
Address.7/^
State License No.52 1/9 r Vilbge License Nn //S^^ ‘ 77^
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
DatCL
Section No.
Parcel No.
Plat No-_
Blodc.Subdivision.
OtIiCT 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
com|dy with the Village Code of Orono applicable thereto^ and shall include all additioiul specifications as listed bdow.
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup;
Install Water Supply Systems:
Install Sewer Hookup:
State Surtax:
Total Amount Paid to Village...
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Fee S
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Fee S
Signature of applicant
A ■
Signature of Village Official
Fees ‘40*9^0