HomeMy WebLinkAbout1967-05-02 Permit, Water Supply Hook Up #1450Village Permit Nq 1450
Contractor —�L�t22°t• r v C�l /b p 1� Address
Owner ��Q ✓Y)le �-- Address -F'
State License No
Village License No
GENERAL PERMIT
VILLAGE OF OAONO
Crystal Bay, Minnesota
Parcel No.
Section No Lot Bloch__ Subdivision
Plat No
Other Description:
Date— 0�
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
In Repair
sewage disposal systems: Fee $
Install
water sapply systems: Fee $ _
Repair �^
_ 7 7 �f" Fee $
Total amount paid to Village........ $_— - - ---
Signaturc of applicant
Signature of Village Offi ial