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Village Permit N? 4 416 <br />Contractor zz ze t�c- t /—'�'-C'/ Address <br />Owner -L Address �di.-�G.srt=!' •,l int <br />State License No <br />Section No. <br />Other Description: <br />Village License No- l( < - •'6 <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />%- ystal Bay, Minnesota <br />Parcel No. --- <br />Plat No <br />Lot _ Block Subdivision <br />Date 5— rJt e 7a _ <br />I hereby agree that, in case a permit is granted, all work which shall be done and 211 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 H(xikup <br />State Surlax <br />total An+„unt Paid t„ S'tllasc <br />Fee S <br />Fee S <br />Fee S ___. <br />Fee S <br />teeS il_ e0 <br />Fee S <br />Fee S '7 f C <br />1Ce� <br />Signature of applicant <br />Signature of :Village Oflirtal <br />�` � t A -. <br />