HomeMy WebLinkAbout1969-07-15 Permit, Water Supply Hookup #2191Village Permit N 2 2191
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Contractor jf / < (, Address
Owner V v& Y-I, u• a I Address `'� « N t
State License
Section No _
Other Description:
Village License N
GENERAL PERMIT
Parcel No
Plat No
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date I— q � /
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 $
Repair
Install
ter supp y systems: Fee $
R i /.
'e Fee $__L
Total amount paid t i Village....... $
Signature of applicant
Signature of Village Official