HomeMy WebLinkAbout1974-05-24 Permit, Water Supply System #3923Village Permit N° 3923
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Owner. Address
Statc 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 5- ,94-74
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: Fee S
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Install Water Hookup:
Fee S
Install Water Supply Systems:
Fee S / O
Install Sewer Hookup:
Fee S
State Surtax:
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Fee S ✓ Q
Total Amount Paid to Village...........
Fee S O '
Signature of applicant
Signature of Village 06cial
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