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�} 'c <br /> V2Y'• <br /> jf� <br /> 1 • <br /> Village Permit N2 2254 <br /> , <br /> Contractor Acldress----{, <br /> Owner -. Address <br /> State License No. Village License No <br /> Y . <br /> •:,s,, <br /> , <br /> F p l� y f kq 1 <br /> GENERAL PERMIT ! !4,` 1)*1 <br /> VILLAGE OF ORONO °i <br /> Crestal Ra}', Minnesota 7 <br /> } . ' / <br /> a.� a 9—// ( 9 <br /> - �. Date_ <br /> ' <br /> „4,' Parcel No <br /> Section No Lot Block Subdivision.. <br /> Plat No <br /> Other Description: <br /> y.i, <br /> lair , <br /> ti : r. <br /> 1 hereby agree that, in case a permit is granted. all work which shall be done and all materials which shall be used, shall <br /> 5 ;' '" comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below. <br /> fie 10 <br /> a <br /> -7T,:,+` <br /> I, ' <br /> r {4r i' <br /> Install plumbing systems: Fee $_ — Signature of applicant <br /> 4+ r' <br /> %install:�_ 0 <br /> -r` sewage disposal systems: Fee $ <br />#,,.....,,,, Rc it <br /> 4' ', <br /> Install <br /> 4., II water supply systems: Fee $ �.�- <br /> � , r'.!+ <br /> x RCIII Signature of Village Official <br /> . <br /> a` _ Fee $_________ /1.,‘ <br /> _..__...__..._._ l/-' / /j//[J/ i //p <br /> 'Total amount paid to Village $ ---- <br /> Y y <br />