HomeMy WebLinkAbout1971-05-05 Permit, Water Supply Hookup #2682Village Permit 7� ,C� vn2
0 a
Contractor"�� �_ G� Address
Owner. �l' Ei�. L`f _ i Z �. �� Address
State License N
Parcel No.
Section No
Plat No
Other Description:
Village License No
GvNERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date
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: Fee $
I astall
sewage disposal systems: Fee $ _
Repair
Install
wate supply systems: Fee $
Repair /�
tl,-" t�—
Fee ;
Total amount paid to/village ....... $
Signature of applicant
Signature of Village ciall
T-4 lr ,' ZM M I Aj Ll -