HomeMy WebLinkAbout1974-12-09 Permit, Water Hook Up #4213v116ge pw.* N° 4213
Contactor °� P- Add t
Owner r,Cl� c �' Address
Statc License No. Village License No
Parcel No
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lo+ BlodSubdivis'
D,t,i2 19-;7y
I hereby agnx that, in case a permit is granted, all work which shall be done and all materiah which shall be used, sW
comply with the Village Code of Orono applicable theretq and shall include all additional specifications as listed blow.
23 Flo 77 �.
51 F737
Water Meter:
Fee S
Sewer Hookup:
Fee S
Install rlumbft Systems:
Fee S.
Install Sewage Disposal Systems:
Fee S
Signature of applicant
Install Water Hookup:
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Fee S O
Install Water Supply Systems:
Fee S
Install Sewer Hookup:
Fee S
Signature of Village Oicial
State Surtax:
Total Amount Paid to Villase...........
Fee S X 1
q Y
Fee S / 2�
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