HomeMy WebLinkAbout1972-12-28 Permit, Sewer Hookup #3502Village Permit 35 J 2
Contractor ;L! A-- Address /r r
Owner 1, . Address
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date 15 — c� J —71---
Parcel No.
Section No Lot Block Subdivision
Plat No.
Other Description:
1 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'age Code of Orono applicable thereto, and shall include all additional specifications as listed below.
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Install plumbing systems: Fee $—
Install
sewage die} -secs: Fee $---41-C r'
Repair
Install
water supply systems: Fee $
Repair
�—
' LL_ Fee
Total amount paid to Village....... $�-
Signature of applicant
Signature of Village Official
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