HomeMy WebLinkAbout1972-12-29 Permit, Sewer Hook Up #3530ti
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,%llage Permit
Contractor Address l � A -A/
Owner. %Address
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORf��4.0
3530
Crystal Bay, Niinnesota
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Date
Parcel No.
Serhon Nn-- Lot Block- Subdivision
Plat No
Other Description:
I hereby agree that, in case a permit is granted, 211 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.
7
71std,1 Plumbing systems: Fee $ Signature of applicant
Install
sewage Fee $ /C
rMoir
Install
water supply systems: Fee
Repair
Fee $
Total amount paid to Village.......
Signature of Village Official
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