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Contractor z J" ° u Address <br />Owner _ ;� _ ' ' ' Address `� (� l / it l <br />State License No. - <br />Village License No. <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date / ` // ' / , <br />Parcel No. <br />Section No. Lot— Block_— Subdivision <br />Plat No. <br />Other Description: <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 />JLJ- <br />"hv Tv., f13 5 s <br />Install plumbing systems: Fee <br />Install <br />sewage dkp oral systems: Fees <br />Repair <br />Install 'n r ' <br />water supply systew: Fee s <br />Itclxur <br />Fee $ <br />'total amount paid to Village....... <br />t , 4, <br />Signature of applicant <br />Signature of Village Official <br />