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Pwne L 4 2 <br />Contractor Add <br />Owner <br />j .. <br />State License No. VJbWe license No <br />s <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Dam / - '2 - 11- <br />Parcel No <br />Section No Lot Block Subdivision <br />Plat No — <br />Other Description: <br />W <br />4f' <br />I hereby agree that, in cast a permit is granted, all work which shall be done and all materials which shalt be used, sW <br />I� comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below. <br />/'.�,� l ,pori. �T � / �►�1.4 <br />Install plumbing systems: Fee $ <br />Install <br />sewage di�04'3rterns: Fee $ C� <br />Repair i <br />Install <br />k <br />water supply systems: Fee $ <br />Repair <br />A. <br />Fee $ <br />Total amount paid to Village....... $ to ' <br />Signature of applicant <br />Signature of Village Official <br />.W <br />