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Contractor <br />Owner <br />State License No._ <br />Parcel No <br />Section No <br />Plat No. <br />Other Description: <br />w <br />rj <br />Village Permit <br />Address <br />Village License <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block— Su <br />Date .5' 4, 7 <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 />Instill plumbing systems: Fee $ —_— <br />Install <br />sewage dist )%al systems: Fee $ <br />Rep ait <br />Install <br />water tiupOY s„leurs• Fee r <br />Itcpaii--�---- <br />Tot.d amount paid to Village....... $ Ar.� <br />f+ »,t E#u ---- '/ <br />Signature of applicant <br />Signature of Village Official <br />;Fri <br />