HomeMy WebLinkAbout1976-06-21 Permit, Water Meter #4461Contractor _ Address
Owner. Tt Address --
State License No. Village Licepse No
Parcel No.
Section No —
Plat No
Other Description:
'pillage Permit N° 4 4 61
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date l • .2 /- 7G
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.
S�fl N
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems
Install Water Hookup:
Install Water Supply Systems:
Install Sewer Hookup:
State Surtax:
Fee $ 0' OO
Fee S
Fee S
Fee i LS'u:re' f pplicanFee S
Fee S
Fee S
Fee S
Total Amount Paid to Village........... Fee S e - -<e
Signature of Village Official
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