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Contractor_.. 1 w f <br />Own— <br />er_�,�,�'�..g� L���_ <br />Address- �/19: IS -6_ <br />Address _ . <br />Village Permif N2 1910 <br />FA <br />0"te4-0 Pte- 'zf <br />Statc License No. _ __ __ _____ _ Village License No. _. <br />Par --el No. <br />Section No. <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Datc S 14-1-9s <br />of B oc <br />I hereby agree that, iii case a pennit is granted, all <br />work which <br />shall <br />be clone <br />acid all inatc:rials which shall <br />be used, shall <br />comply with the Village C;odc of Orono applicable <br />thereto, and <br />shall <br />iiiclude <br />all additional specifications as <br />listed below. <br />Install plumbi>>g systems: <br />Install <br />sc.'s'iige disposal systems - <br />Repair <br />1 nstall <br />water supply -,}-steins : <br />epa�ii.' <br />Total anioutit paid to \ illagc .. . <br />14, cc $ ___ . _____ <br />Fee $ <br />Signature of applicant <br />signaturc 0 Ill-1ge ()fltiC JI <br />Fee <br />1 <br />