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Village Permit N° 4197 <br />Contractor Address <br />Owner Address 4f 2=E J). /" o <br />Statc Licensc No. Village License No <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block Subdivisio*+ <br />Date Lk*7 - 3 -- -7 S' <br />I hereby agree that, in rase 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 />Water Meter: <br />Sewer Hookup: <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />Install Water Supply Systems: Fee S <br />Install Sewer Hookup: Fee S <br />State Surtax: Fee S <br />Total Amount Paid to Village........... Fee S <br />Signature of applicant <br />Signature of Village Official <br />WiIzq" i A"'- <br />