HomeMy WebLinkAbout1969-09-11 Permit, Water Supply Hook Up #2251Village Permit N 2 2251
1-Y\
Contractor � c Addres
Owner 6 SS '� Address i7dc
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date
y_ y
Parcel No
Section No Lot Bloch_. 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
Repaer su ply systems: Fee $
LL Fee $�
Total amount paid to Village....... $
Signature of applicant
Sign+ re of Village Official