HomeMy WebLinkAbout1968-09-13 Permit, Septic System #1958Village Permit N" 1958
Contractor la r r Address / 447Ad
Owner. n rr �� Address
State License
Section No
Other Description:
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date !Z /
Parcel No.
Lot— Block Subdivision —
Plat No
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:
sewage disposal systems
Repair
Install
water supply systems:
Repair
Fee $ —
Fee $
Fee $
Fee $
Signature of applicant
Signature of Village Official
Total amount paid to Village........ $—_ - —