HomeMy WebLinkAbout1964-08-31 Water Supply Hookup #603rc�
Village Permit No 603
Con tractor 19ZrI-0� Address
Owner Address- /22101i-�z
State License No Village License No
GENERAL PERMIT
VILLAGE OF OAONO
Crystal Bay, Minnesota
Date.
F/ 3 / 04
/ 'T' 4
Plat No
Section No c� ,o Parcel No— LiOi�-- Bloc Subdivisi•+ G
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.
Install plumbing systems: Fee $
Install
sewage disposal systems: Fee $
s'
Install water supply systems: Fee $
epw ,SO
L�0 Fee $7 d
Total amount paid to Village....... $�
Signature of applicant
Signature of Village Official