HomeMy WebLinkAbout1973-04-24 Permit, Water Supply SystemVillage Pormit 3609
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Contractor- / Address
Owner� '�{ -i'X,' ����Address `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 u ced, 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:
Install Water Supply Systems:
Fee S
Fee S
Fee S
Fee $
Fee S
Fee S TQ " lZf2
Signature of applicant
Install Sewer Hookup: Fee S
Sio ature of Village Official
State Surtax: Fee S 11:j
Total Amount Paid to Village........... Fee S --� 1� f