HomeMy WebLinkAbout1967-09-11 Permit, Water Supply Hookup #1623Village Permit N° 1623
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Conhactor d/ /,- 6 Address
Owner 7'i . U6 �D / fif Address_ _% J� / 2
State License No _ Village License No.
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date 1-/1-617
Parcel No.
Section No Lot Block Subdivisi
Plat No
Other Description:
I hereby agree that, in case a permit is granted, all work which shall be clone 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
Repair sewage disposal systems: Fee $
Install
ter supply systems Fee $ _
Repo j j
_ Fee $
Signature of applicant
Signature c; Village O ' I
c.
Total amount paid to Village........ $