HomeMy WebLinkAbout1974-11-12 Permit, Sewer Hook Up #4048Village Permit 4148
Contractors �G f K t '` Addr /!
Owner__��� ,n x a �i I its 1t rt r •�� // 1 C / / {. /'
Address �-/-(� J v / • .� � -r1 d � t'o /� G/ .
State License No
Section No
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Other Description:
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Parcel No. _
Plat No
Lot 3l0ck Subdivision
Dates
I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, sh,il
comply with the Village 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:
State Surtax
Fee S
Fee $
Fee S
Fee $
Fee $
Fee $ _
Fee S ` C�
Fee S _ r'
Total Amount Paid to Village........... Fee $
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--'ature of applicant
Signature of Village Official