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Contractor' <br />.d e te <br />State License No <br />YJ690 PW"* <br />Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No <br />Six -tion No Lot Block Subdivision <br />Plat No <br />Other Description: <br />0 <br />N2 2596 <br />Date I r ' ? 0 <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 spe ifications as listed below. <br />Install piumtmng systems: Fee $ <br />Install <br />sewage disposal systems: Fee $ <br />�r,�, <br />water supply systems: Fee $. <br />Repair <br />Fee <br />Total amount paid to Village....... $ <br />Signature of applicant <br />Signature of Village Official <br />I / <br />