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V w-^^isrni^ ^ <br />i ‘ .• <br />,4M'S <br />■'f.>. <br />Villag* Pam^ f^'O 3277 li-; <br />Contractor.Jc.r <br />Owner—C^[flhx dTij Address— <br />Address__f Lk <br />/< 4 f o /h /V . <br />^ ■ . 1 <br />State License No..Village License No, <br />GENERAL PERMIT <br />VILLAGE OF ORCNO <br />Crystal Bay, Minnesota <br />fn Date._4 r i <br />Parcel No..^ ■ <br />r. :-v j Section No.Lot Block.. Subdivision.,C-' <br />Plat No <br />Other Description: <br />*W: y. <br />I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shall <br />comply with the Village Code of Orono applicable thereto, and shall include all additional spcxafications as listed below.m <br />.4 • <br />Install limbing systems: <br />Install <br />I'ce $.Signature of applicant <br />-*P" <br />Repair <br />sewage disijosal systems: Fee $. <br />I •'.Install , <br />Witif snp^Fee $ ^ <br />Kcjxiir Signature of V illage Official <br />I' ce $.C' <br />Total amount paid to Village...........t ■ 0 > ^C (L <br />■ I <br />___A... <br />I RiMfAfci 111