HomeMy WebLinkAbout1971-05-05 Permit, Water Supply Hook Up #2683Village Permit G 6 033
Contractor Address
Owner Address
State License No Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Mi. ota
Date
Parcel No.
Section No Lot Block Subdivision
Plat No
Other Description:
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 $
Install
sewage disposal systems: Fee $ —
Repair
Install
Z4k
supply systems: Fee $
Repai
Fee $
Total amount paid to illage....... $
Signature of applicant
,Signature of Vt'Wge
Lt'-