HomeMy WebLinkAbout1975-02-18 Permit, Water System Hook Up #4089Village Permit N° 4089
Contractor Pit, * 1) Address
Owner `/ '► Address 6 fl
State License No. Village License No
Parcel No.
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date ,J--/D —1-
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:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Srstcros.
Install Water Hookup:
31-1 o
112-1
Fee S Y�
Fee $
Fee S
Fee S Signature of applicant
Fee S
Install Water Supply Systems: Fee S
Install Sewer Hookup: Fee S
State Surtax: Fee S S;i)
Total Amount Paid to Village........... Fee S.111
Signature of Village Official