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/ r <br />Contractor_ <br />Owncr - <br />State License N <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />Address ' A <br />�— :Address -� <br />Village License No. <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Village Permit No <br />Crystal Bay, Minnesota <br />Drat �� <br />Lot Block_ ____ Subdivision _ _ <br />1253 <br />I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shall <br />comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below. <br />i <br />Install plumbing systems: Fcc $— <br />Install <br />Repair sewage disposal systems: Fec �— <br />Install <br />water supply s}stems: Fee— _ <br />Repair -M 2� � <br />Fee <br />Total arnoant paid to Village........ S---- -- --- <br />Signature of applicant <br />Sigualurc of Village Official <br />