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�Ra�i�:.r'''''i1'�,M/'wl�'."T74`iNw'�7� •'s'.'+i'G=�l}�,i4n,��1�1 <br />Village Permit 11 ' 5 .2 <br />Contractor__ ' Address <br />Owner"n�J C Address <br />State License No. Village License No <br />GENERAL PERMIT <br />Parcel No._ <br />Section No <br />Plat No <br />Otter Description: <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block Subdivision <br />Dat, <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 specifications as listed below. <br />Water Meter: <br />Fee S <br />Sewer Hookup: <br />Fee S z x <br />Install Plumbing Systems: <br />Fev 5 <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup. <br />Fee $ <br />Install water Supply Systems <br />Fey '.1 — <br />Install Sewer Hookup <br />Fee S <br />State Surtax: <br />Fee S 40 <br />Total Amount Paid to Village I . Fre S / r " Y r <br />Signature of applicant <br />Signature of Village Official <br />n! : <br />