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Before digging call focal utilities <br />TELEnHvNE - ELECTRIC - {„•.S".r <br />Etc. <br />REQUIRED BY LAW <br />Y8.LAGE OF Lft[Lt <br />utmontg e wo. <br />RAMSEY COUNTY No <br />PLUMBING PERMIT <br />WELL DRILLING PERMIT <br />Total Fee Structure <br />Collected Used As <br />Double Fee <br />PERMISSION IS HEREBY GRANTED <br />Contractor <br />Addrese <br />it on the following described property, subject to all rules and regulations and provisions of <br />other applicable rules, regulations and provisions of law enacted and promugated by municipal, <br />revoked upon violation of any of the above stipulations. <br />Owner <br />Address__ <br />To carry out the work specified in this <br />the Building Code or Village ordinances, a <br />state and /or federal authority, and may be <br />N9 2984 <br />Date <br />NUMB <br />STREET <br />SIDE <br />BETWEEN WHAT STREETS <br />LOT <br />BLOCK <br />ADDITION OR TRACT <br />SIZE OF WEIL <br />LOCATION OF WELL <br />CHARACTER OF WELL <br />Water Closet Automatic Washer Catch Basins Drinking Fountain <br />Urinal Bath Tub Drill Well Sewer Line Sanitary <br />Gas Stove Shower Bath Kitchen Sink Sump <br />Two Laundry Trays Water Heater Wash Basin' Sewer Septic <br />Floor Drain Garbage Disposal Dish Washer <br />DETAILS OR REMARKS <br />APPLICATION <br />The undersigned hereby makes application for a permit to do Plumbing Work as herein specified, agreeing to do <br />all work in strict accordance with all ordinances of the Village of Little Canada. <br />SIGNED <br />ADDRESS <br />PENALTY FOR VIOLATION OF ANY OF THE PROVISIONS OF BUILDING CODE OR ORDINANCE: FINE FROM <br />FIVE DOLLARS TO ONE HUNDRED DOLLARS OR IMPRISONMENT FOR FROM FIVE TO NINETY DAYS. <br />For the VILLAGE OF LITTLE CANADA <br />PAGE ® 1 e <br />