HomeMy WebLinkAbout1967-09-01 Permit, Water Supply Hook Up #1609Village Permit N! 1609
Contractor J ' f Addressj4e'
Owner Add - c:17-4
State license
Parcel No.
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
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:
Install
sewage disposal systems
Repair
Install
water supply systems:
Repar on
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Fee $
Fee $
Fee $ _
Fee $
Signature of applicant
�)[t;IJaWrc of Village 01"I
Total amount paid to Village........ $___ - __