HomeMy WebLinkAbout1967-06-08 Permit, Repair Water Supply #1512Village Permit No 1512
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Contractor F L2��_ _ Address —
Owner 61, Q fi Address ` f -2 c re J--i "'
State License No Village Licensc No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Dat y
Parcel No.
Section No Lot Block Subdivision—____—_
Plat No
Other Description:
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.
Inst-11 plumbing systems:
Install
sewage disposal systems:
Repair
Install
_--ti water supply systems:
Fec $ Signature of applicant
Fee $ _
Fee $�.L a -
Fee $
Signature of Village Official
Total amount paid to Village........ $— - -- -- -