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Contractor <br />Owner <br />Address— <br />161 Address <br />Village Permit NOO 3986 <br />State License No. Village License No <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal filly, Minnesota <br />Dat �'-If <br />Lot Block_______ Subdivision <br />I hereby agree that, in case a permit is granted, all <br />work which <br />shall <br />be dons: <br />and all materials which shall <br />be used, shall <br />comply with the Village <br />Code of Orono applicable <br />thereto, and <br />shall <br />include <br />all additional specifications as <br />listed Wow. <br />Water Meter: Fee S <br />Sewer Hookup: Fee S <br />Install Plumbing Systems: Fee $ <br />Install Sewage Disposal Systems: Fee $ <br />Signature of applicant <br />Install Water Hookup: Fee $ __ 0 <br />Install Water Supply Systems: Fee $ _ <br />Install Sewer Hookup: Fee S <br />Signature of Village Official <br />State Surtax: Fee S <br />Total Amount Paid to Vill;ige .... Fee S <br />