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Village Permit <br />Contractor <br />Owner t {�7'1-� uC 2. A�t�. ��` (C �ic ��. ��k i�y�- l� `✓ <br />y43t0-.(r[aoep <br />State License No. Vil1W IAv= No <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF OIR <br />Crystal Bay, Minnesota <br />Block_ Subdivision► <br />Date <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 211 additional specifications as listed below. <br />94 (A 'C <br />ter: Fee S <br />i <br />okup. Fee S C� <br />Install Plumbing Systems. Fee S <br />Install Sewage Disposal Systems Fee S Signature of applicant <br />Install Water Nookup Fee S itL <br />Instill Water Supply Systems. Fee $ <br />I nN ntt 4evow 111 ttlp : `�. � C. Fee i i <br />Signature of %'illW Official <br />Slate Surtax FN s �,� � Q <br />f � <br />Total Amount Nod to Village ........ FN S f <br />