HomeMy WebLinkAbout1974-12-19 Permit, Water Hookup #4071.w'�S�Yfi�W.siy.,�`� :. •.�c1P � ` •v.. •t.. .•„y v.,«� +. ✓rt� a., �y,., ,qr
Village Permit 4171
Contractor vG�
Address
Owner Address IL- A 6 sr
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State Licensc No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date L2 14' 7 LI
Parcel No.
Section No Lot Block Subdivision
Plat No
Other Description:
I hercby 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.
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Water Meter:
Sewer hookup:
Install Plumbing Systems:
InstA-Sewage Disposal Systems:
Install Water Hookup:
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Fee $ u
Fee $
Fee S
Fee S
Fee $ L'%• r o
Install Water Supply Systems: Fee S
Install Sewer Hookup: Fee S
State Surtax: Fee S
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Total Amount Paid to Village........... Fee S
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Signature of applicant
Signature of Village Official
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