HomeMy WebLinkAbout1976-05-20 Permit, Sewer & Water Hook Up #4419Village Permit N° _ 4 419
Contractors Address --
Owner �� _.J�� Address '
State License No
Parcel No.
Section No
Plat No
Other Description:
Village License
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
LA It Block Subdivision
Date S -20 - 7C
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 C,de of Orono applicable thereto, and shall include all additional specifications as listed below.
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 R61,00
Fee S
Fee S Signature of applicant
Fee S
Fee $
Fee S
State Surtax: Fee S l • s 0
Total Amount Paid to Village..... Fee S 36, od
Signature of Village Official