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-•*-4 T — 1^ <br />i <br />4 <br />n» <br />^5^ <br />,1^ <br />Contractor.ll/J <br />Village Permit 4004 <br />Pii“n, <br />TutA^ <br />• i.X«A.b. . _. <br />Owner.< tL-i^ <br />State License No. <br />Addresi <br />Addresi f)0 a^<'i~(LJD <br />y^c#o <br />Village License No. <br />GENERAL PERMIT <br />"■^pp ' -T^4 <br />^ VILLAGE OF ORONO <br />*1-" <br />C.Jtal Bay, Minnesota <br />Date. <br />Parcel No.. <br />Section No,Lot Subdivision. <br />Plat No <br />Other Description: <br />; <br />■ *! <br />*. •■ <br />r:. <br />I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be oaed, «»«!» <br />comply with the Village Code of Orono applicable thereto^ and shall include all additional specifications as lilted bdow. <br />____________________________________________________ __________________________________________________________________________________________ <br />W <br />Water Meter; <br />Sewer Hookup:Fees <br />Ins^ Plumbing Systems: <br />liftstall Sewage Disposal Systems: <br />Fee S <br />Fee S <br />Install Water Hookup:Fee S <br />Install Water Supply Systems:Fee $ .n.^ <br />Install Sewer Hewkup:Fees <br />State Surtax;Fees <br />Total Amount Paid to V'iUajie ............ <br />'T' <br />, ... Fee S ' <br />Signature of applicant <br />■S^Signature of Vilhige Official <br />/y)f fCc. <br />; i <br />,4#V <br />__