HomeMy WebLinkAboutPermit, Pump Repair #1489Village Permil N! 1489
Contractor ---=-�� ���'L_ Address
Owner_ /Q � Pik .----- .Address
State License No._____ _ _—_ ___ ___ Village License No.
GENERAL PERMIT
Parcel No.
Section No
Plat No
Other Description:
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block--_ Subdivision_
Date
I hereby agree that, in ease 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:
Install
Repair sewage disposal systems
Install
Fee S— -- Signature of applicant
Fee _
Repair r supply systems: Fee b _
—_ _ Fee �—
Total amount paid to Village........
Signature of Village 1161 1