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Village Permit N o 2165 <br />Contractor_ C� C' C �{ Address —Ay 4 Itl, j } e tr. J <br />_ <br />Owner 41f/G�.4' Address n u Ci r <br />State License No <br />Parcel No <br />Section No <br />Plat No <br />Other Description: <br />Village License N <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot_ Block_ Subdivision <br />Date <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 />Install <br />sewage disposal systems: <br />Repair <br />tsI n's'ta <br />watcr supply systems: <br />Repair <br />Fee $ _ <br />Fee $ <br />Fee $ <br />Fee $-- <br />Total amount paid to Village....... $— <br />Signature of applicant <br />Signature of Village OTcial <br />