HomeMy WebLinkAbout1974-10-09 Permit, Sewer Hook Up #4030Village Permit
Address
Address �J J �' d ) f�
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date
Parcel No.
Section No Lot Block Subdivision
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.
Water Meter:
Sewer Hookup:
Install Plumbing Systems:
Install Sewage Disposal Systems
Install Water Hookup:
Fee S
Fee S ff
Fee S
Fee S
Fee S
Install Water Supply Systems: Fee S
Install Sewer Hookup: Fee S
State Surtax: Fee S C-
Total Amount Paid to Village........... Fee S /C -�4,
Signature of applicant
Signature of Village Offici;
`fin, � �: - ,