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Village Permii No 1213 <br />Contractor r� CA �n '� Address ' <br />I ", le er A 14 4—V4 1 <br />'! (/ <br />Owner�� � - �' v Address <br />State Lc. -:se No._ <br />Parcel No <br />Section No <br />Plat No <br />Other Description: <br />\ illage Liccnsc No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, :,iw.,esota <br />i� <br />Datc_--74 <br />i <br />l <br />Lot Block Subdivision—___ _ <br />I hereby agree that. in case a permit is granted, all work which shall be done and all waterials which shall be used, shall <br />comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as ?isted below. <br />Install plumbing systems: <br />Install <br />sewage disposal systems <br />Rcpair <br />nsta <br />water supply systems: <br />Repair <br />Fee -- <br />Fee $ <br />Fee $ /0' d�_ <br />Fee $— — <br />Total amount paid to \ illagc........! • �� <br />Signature of applicant <br />Signature of Village vial <br />� A& C.Q <br />