HomeMy WebLinkAbout1967-09-06 Permit, Water Supply System #1614Village Permit N! 1614
Contractor t�ten r' Address
Owner— w _, 11_Q l?1.� Address 16 7� G / ✓1
State Liccnsc
Parcel No.
Section No
Plat No
Other Description:
Village Liccnsc No. —
GENERAL PERMIT
V '.NLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
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 Villagc Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Install plumbing systems:
Fee $
Install
sewage disposal systems:
Fee $
9r
Ins
Fee $ �'C
R it water supply systems:
epa
--
Fee $
Signature of a�)plicant
Signature of Village cial
Total amount paid to Village........ $— - -