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Contractor ' _�r L AQ Address <br />Owner. r'1 Address-- <br />State <br />ddress <br />State License No. — Village License No <br />Parcel No. <br />Section No <br />Plat No. <br />Other Description: <br />Village Permit N° 4239 <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Ray, Minnesota <br />Lot Block Subdivision <br />Date " A-7 S` <br />I hercb)' 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 />Sewer Hookup: <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems <br />Install Water Hookup: <br />Install Water Supply Systems: <br />Install Sewer Hookup: <br />Fee S <br />Fcc S % L <br />Fee S <br />Fee S <br />Fee S <br />FeeS�A-- <br />Fee S <br />State Surtax: Fee S /' to c <br />Total Amount Paid to Village........... Fee S <br />Signature of applicant <br />Signature of Village Uffici 1 <br />