HomeMy WebLinkAbout1972-12-29 Permit, Sewer Hook Up #3531.I A
Village Permit
Contractor - ,f ��' 2 Address
Owner � �; � ,'-'' a{ C. 7") .G 6/C Address
State License No. ---- Village License No. —
Parcel No..
` ,Section No
1
Plat No. —
Other Description:
GENERAL PERMIT
VILLAGE OF OEONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date
hoc .
1 hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shall
icomply with the Village Code of Orono applicable thereto, and shall include all additional speci5cations as listed below.
i
1 '
Install plumbing systems: Fee $
Install f �, O
sew,.-e disposal vatbins: Fee $
Rclrair
Install
water supply systems: Fee $—
Rcpair
-- ----- - Fee
Total amount paid to Village....... $
Signature of applicant
Signature of Village Official