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Village Permit <br />1 3188 <br />Contractor /a- �- - Address <br />Owner Address <br />i <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No. <br />Section No <br />Plat No _— <br />Other Description: <br />Lot_ Bloch— Subdivision <br />Date <br />--7 L <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 />Install plumbing systems: <br />Fee <br />Install <br />sewage disposal systems: <br />FLe $ <br />Repair <br />Install <br />water supp <br />Fee <br />Repair <br />T— <br />r <br />Fec $— <br />Total amount paid to Village....... <br />$ / <br />Signature of applicant <br />Signature of Village Official <br />