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Village Permif fjo 1380 <br />Contractor. <br />Owner, <br />^ - T <br />hj~7^r '!< <br />State License No, <br />Section No, <br />Other Description: <br />/ <br />Add re S’*.dy\ <br />n //- J^/f <br />X'illage License No.. <br />general permit <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No. <br />Plat No__Lot Block Subdivision. <br />Date / / J/ 7 ^ <br />Install plumbing ssstcnis: <br />Install <br />Repair ‘Jis|)osal systems: <br />Install <br />I 'cc $. <br />Fee $. <br />Rqp4r'‘“_y'PP ‘>' <br />Total amount jjaid to Milage__ <br />I'ce $. <br />Fee %.:^o <br />■ •. S--------------------- <br />Signature of applicant <br />Signature of N'lllagc Official <br />'hu tc cdit/hA^