HomeMy WebLinkAbout1966-09-14 Permit, Water Supply System #1275Village Permil N" 1275
Contractor r 6 r1' z o •1 — �a 6 W f Address—_ / ! t0 rI �a
Owner—_L x v I f- P flE Address e S S pe-
State License No
Section No
Other Description:
Village License
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Datob
Parcel No.
L,ot Block Subdivision
Plat No
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 blow.
Install plumbing systems:
Install
sewage disposal systems:
Rr%Mp
water supply systems:
Repair
Fee $
Fee $
Fee$ /O••O
Fee $_
Total amount paid to Village........ $/ �'—()--
Signature of applicant
Signature of Village Official