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Contractor_-_s,.e%�Address . <br />Owner__ L. 1 ; <br />Village Permit No <br />2096 <br />State License No.__ . _ _ Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No. <br />Section No. Lo.. _.___ _. Block._ Subdivitiiun_ _ <br />Plat No <br />Other Description: <br />I hereby agrec that, in case a permit is granted, all work which shall he dome and all inateriah 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 />Install pluml,ntg systcrns: Fee 9, _ _--_—_--- <br />Install <br />Repair sewage disposal systems: Fee <br />1 nstall <br />water supply svitems: 1"ee _ <br />i 11 ePair <br />E"'Nt___. <br />'Total amount Iwul to \ iilage.... $-- <br />Siglwturc of applicant <br />signature of \ illagc Of6cwl <br />