HomeMy WebLinkAbout1974-02-25 Permit, Water Supply #3867Village Permit N° 3867
Contractor c _'. k aUX�L- Ali 141 Addres
Owner Address cT& "(- �;d `
State License No. Village License No
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date " : J — 7kk
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: Fee S
Sewer Hookup:
Fee S
Install Plumbing Systems:
Fee S
Install Sewage Disposal Systems:
Fee S
Install Water Hookup:
Fee S
Install Water Supply Systems:
Fee S / it)
Imctall Sewer Hookup
Fee S
State Surtax:
Fee S J c
'total Amount Paid to Village...........
Fee S to 50
Signature of applicant
Signature of Village Official