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■ wiiiva f ------ <br />V t <br />•L * 9 <br />Contractor.0l_Address. <br />Village Permit 4211 <br />^ u <br />yp yy’.4, <br />Owner. <br />-A , «r <br />Address.3 O y-K r.'2 /\ <br />. 7‘/--siT <br />State License No..Village License No. <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date:Zl- Z- <br />Parcel No.. <br />Section Nc Lot Blodc.Subdivisioit <br />f Plat No. <br />/ <br />Other Description: <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 />.1 1 a / ^ _________________________________________________ <br />3 <br />Water Meter:Fee S.jTf .3 f <br />Sewer Hookup: <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: <br />Install Water Supply Systems: <br />Install Sewer Hookup: <br />State Surtax: <br />Fee S <br />Fee $ <br />Fee $ <br />Fees / c>. c iy <br />Fee $ <br />Fees <br />Fee S <br />Total Amount Paid to Village...................Fee S 2 <9. 7/ <br />Signature of api^icant <br />I <br />'C <br />Signature of Village Official <br />,]1 <br />t I <br />^ A