HomeMy WebLinkAbout1965-08-04 Permit, Water Supply System #867Village Permit Na 867
Contractor, ) >���� Address_---- /fit
Owner Address—____—_ a
State License No. —______ Village License No.�
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date —
Parcel No.__.-___ i
Section No. Lot Block Subdivision
Other Description: Plat No.—__
or
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
sewage disposal systems
Repair
Install
water supply systems:
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Fee $ —_
Fee $--__ —
Fee $14 _�_
Fee $___
Total amount paid to Village....... $a-
Signature of applicant
Signature of Village Official
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