HomeMy WebLinkAbout1971-05-05 Permit, Water Supply Hook UpContractor L'� =t1 ✓ �Ch fr"a c. fc r"
Owner X.A tA'rl
State License
Parcel No.
Section No
Plat No.
Other Description:
vid6p Pwnf*
Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Lot Block Subdivision
Date .2
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: Fee $
Install
sewage disposal systems: Fee $
Repair
Install
asupply systems: FeeRepai�
Fee $ a, � x �_•
Total amount paid tb Village....... $
I
Signature of applicant
Signature of Village 01fiCi2l