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<br /> �/ ` -------- Address- � 90� i ,N.c--r�S-��f--a.�_s� /�-
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<br /> State License No Village Li �
<br /> �� cense No _
<br /> 'i GENERAL PE �.
<br /> RIVIIT �
<br /> �. VIL�,AGE OF ORONO
<br /> �..' , � _ Crystal Bay, Minnesota
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<br /> V Dat�—� - Z� �Y ' ,�'
<br /> . Parcel No '�
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<br /> . Section No . w
<br /> � . ��--- Block Subdivision
<br /> �- Plat No � � ;r;
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<br /> �'� }I hereby agree that, in case a rmit is ' ` ;,�� rr ` �` "' �
<br /> pe granted, all work which shail be'done anc} all materials which shall be ` a��`.�
<br /> ��`��com with the Vil usocl, shaD
<br /> . �. �� P�Y lage Code of Orono applicable tnereto, and shall include al� additional s � ~ ���
<br /> �.* " . _, � pecifications as list�ed Y `�' ,
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<br /> Install plumbing systems: F� g__ � �. ,:�_
<br /> Signatare of appliqnt � +�W ,�,.
<br /> . Install .. ,. s;
<br /> �: �Itepair �Be . Fee $ ��. O ?t �r �t�',;
<br /> �^ Install `1�c,_ -;c`;� ��
<br /> - _lr water s�P'P�Y-��3�� Fee ���! �7 �. / i''.V �,,� . '�
<br /> ,;.} :f Repa. .� � ���9 � �"�„��
<br /> �." — •��.`L" ' Fee g�. 7 �gnature of Village O�cial �r
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<br /> Total amonnt paid to Village....... � -� /� n ;��;;1'1 � �%
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