HomeMy WebLinkAbout1964-10-01 Permit, Water Supply System #643Village Permit No 643
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Owner!' l' r Address
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State License No.— Vike License No.
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
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Parcel No._K �/- �'
Section No-1—__ Lotl____ Bloch—_.__ SubdivisionT��'-�%!r� Est,
Plat No —
Other Description:
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.
Install plumbing systems
Install
Repair sewage disposal systenis
Install
uwater supply systems:
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FCC $__ _ Signature of applicant
FCC
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Fee $_i._Q. _
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Fee $_- Signature of Village Official
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Total a►. ount paid to Village....... $_