HomeMy WebLinkAbout1973-07-11 Permit, Water Hook Up #3699Village Permit - - 3399
Contractor Address
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Owner !��L. O�G'-2 Address 42..a,
State License No
Parcel No.
Section No --
Plat No
Other Description:
Village License No
GENERAL PERMIT
VILLAGE OF OE ONO
Crystal Bay, Minnesota
Lot Bloom Subdi ision
Date /' // — 7
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 211 additional specifications as listed below.
Water Meter:
Fee S
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S
Signature of applicant
Install Sewage Disposal Systems:
Fee S _
Install Water Hookup:
Fee S e d
(�- _ • _ �, ��-
Install Water Supply Systems:
Fee $
Install Sewer Hookup:
Fee S
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Signature of Village Official
State Surtax:
Fee S —0
Total Amount Paid to Village...........
Fee S ��_�1d�Q�(,
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