HomeMy WebLinkAbout1974-08-22 Permit, Water Meter #3989Village Permit
Contractor-6 '� ��ti Address
Owner Address Y'a'�-
State License No. Village License N
Parcel No.
Other Description:
GENERAL PERMIT
VILLAGE
Crystal Bay, P "-inesota
Date 9 `Z' Y — I c-
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.
Jy v,13 J 3 9 --
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Fee Ste_
Install Sewage Disposal Systems: Fee 5
Install Water Hookup: Fee S
Install Water Supply Systems: Fee S
Install Sewer Hookup: Fee S
State Surtax: Fee S
Total Amount Paid to Village........... Fee S
Signature of applicant
Signature of Village Official
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