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Village Permit N° 4494 <br />Contractor,. h'2L`? d1 Address <br />Owner A `� Address f f :5 Z) <br />State License No <br />Parcel No. <br />Section No <br />Plat No. <br />Other Description: <br />�._ Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crysta; Cray, 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 ased, shall <br />comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as 1►st:v below. <br />Water Meter: <br />Sewer Hookup. <br />Install Plumbing Systems. <br />Install Sewage Disposal Systems <br />Install Water Hookup: <br />Fee S <br />Fee S yf <br />Fee S <br />F` S Signature of applicant <br />Fce S � s <br />Install Water Supply Systems: <br />Fee S <br />Install Sewer Hookup: <br />Fee 5 ' <br />State Surtax <br />Fee S <br />Total Amount Paid to Village..... <br />Fees <br />Signature of Village: Official <br />