HomeMy WebLinkAbout1976-01-29 Permit, Water Supply System #4328Village Permit N° 4328
Contractor—fidD0Z,4 i4l,6-4I— Address
Owner 100/Z1,-Y 1/101"AFF/lEY Address 10E5-- ltl, f"E,CA,104jE
State License No. /7%2 Village License No 11Z
Parcel No
Section No
Plat No
Other Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota l p
Date /'�' -� /
Lot Block Subdivisi
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 .
_
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fec S
Install Sewage Disposal Systems:
Fee S
Install Water Hookup:
Fee S
Install Water Supply Systems:
Fee S
20. BO
Install Sewer Hookup:
Fee S
State Surtax:
Fee S
' SO
Total Amount Paid to Village.
Fee S
Signature off applicant
Signature of Village Official