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Contractor <br />1�i7X 4,41 <br />_ Address <br />Owner77 <br />C� <br />—. Address <br />State License No. Village License No. <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />Village Permit <br />N2 2361 <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot- Bloc Subdivision <br />Date �� ;- � 6 <br />I hereby agree that, in case a permit is granted, all <br />work which <br />shall <br />be done <br />and all materials which shall <br />be used, shall <br />comply with the Village <br />Code of Orono applicable <br />thereto, and <br />Tall <br />include <br />all additional specifications as <br />listed below-. <br />Install plumbing systems: Fee $�_. <br />Install <br />sewage disposal systems: Fee <br />Repe i r <br />Install <br />waver supply Systems.- Fee <br />!Zc } rF ' <br />A. <br />Total amount }xaid to Village ....... - ..... - <br />Signature of applicant <br />Signature of Village OffvdW <br />