HomeMy WebLinkAbout1972-12-28 Permit, Sewer Hook Up #3503Contractor'+
Owner
State License No.__
Village Permit '
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Address 1
Address
Village License No._
GENERAL PERMIT
VILLAGE OF ORONO
Cn•stal Ray, Minnesota
Parcel No.
Section No. Lot--- Block _ Subdivision
Plat No.— _
Other Description: �.
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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 all additional specifications as listed below. r�
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Install plumbing systems: FCC $
Install ILlei
sewage dist.aw4-srt Fee $_
itcpair
Install
water supply systems: Fee $
Repair f
Fee $— , Total amount paid to Village....... $y.:
Signature of applicant
Signature of Village Official
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