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Contractor /C J. <br />_. <br />Owner <br />D4• <br />Pte, Qom. <br />Village Pe(rMt <br />N4 3985 <br />Address_ _ <br />Address 311 g,4 <br />State Licensc No._ Village License No. <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No, <br />Date V t 74 <br />Section No Lot Block Subd ivisio� <br />Plat No. <br />Other Description: <br />1 hcrcb%, agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shin <br />comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed Wow. <br />w,ItL*r Mrtrr <br />Sewer Ifoo kuj) I cc �+ _ <br />Install Plumbing Systems. <br />I���t.�" �� �� .�►:� Disposw Systems: <br />1w,tA1 \katcr Hookup: <br />Inbtall Watcr Supply Systems: <br />Install Sewer Hookup: <br />State Surtax: <br />I(ItaI Aiiiouiit Paid tt) ViII.jtr. <br />I -L -L, S <br />V S <br />F t.0 1� /1) . C 44N <br />Fer <br />I %' S <br />Fee S <br />F cc <br />i� <br />Signature of applicant <br />Signature of Village Official <br />04 <br />�► <br />� I ( 'C <br />