HomeMy WebLinkAbout1974-07-19 Permit, Septic System #3971Contractor.
Owner
State License No
Parcel No
Section No_
Village Permit N° 3971
Address
Address /C
Village License N
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Plat No.-
Other Description:
Lot— Block Subdivisi
Date �- %
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 Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Water Meter:
Fee S
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S _
Install Sewage Disposal Systems:
Fee S
Install Water Hookup:
Fee S
Install Wat r Supply Systems:
Fee S
Install Sewer Hookup:
Fee S
State Surtax:
Fee S
Total Amount Paid to Village...........
Fee S C%
Signature of applicant
Signature of Village Official /
C) 4 li-'e00/�