HomeMy WebLinkAbout1973-06-22 Permit, Water Hook Up #3675Village PermO .: 3375
Contractor Addresses
Owner �, , Q 6..cYL- Address
Statc License No. Village License No
3
Parcel No.
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
/2 2 V-1
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.
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Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems:
Install Water Hookup:
Install Water Supply Systems:
Install Sewer Hookup:
Fee S
Fee S
Fee S
Fee S
Fee S
Fee S _
Fee S
State Surtax: Fee S
Total Amount Paid to Village........... Fee S '
Signature of applicant
Signature of Village Official
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