HomeMy WebLinkAbout1973-06-28 Permit, Water Hook Up #3683`.," �'�tiTer'4;r�!+e��. . i�' i� �-. ' -'• ;` ,•''�`ati. '��iiti'.. "r'. 7�` "'7r' T ^ r'*:. --"r • r.' 7r„r - .. . r�-,. a .r ; �c,
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Village Permit 3 S v
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Contractor ' ` c 'r Address
Owner x Address
State License No. —
Parcel No.
Section No
Plat No
Other Description:
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Bloch _ Subdivision
Date Z- )4- 75
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 Vil ge Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems
Install Water Hookup:
Install Water Supply Systems -
Install Sewer Hookup:
Fee S
Fee $
Fee S
Fee $
Fee S C r—)
Fee S
Fee S
State Surtax: Fee S
n �
Total Amount Paid to Village........... Fee S
Signature of applicant
Signature of Village Official