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Village Permit N° 4563 <br />Contractor ? �� �{ r L .r !� < < ^ Address <br />Owner zYa, J.'`Address <br />State License No <br />Parcel No <br />Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date ''� 2c, <br />Section No Lot Block Subdivision <br />Plat No <br />Other Description: <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 />Water Meter: <br />Fee S <br />Sewer Hookup: <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: <br />Fee S <br />Install Water Supply Systems: <br />Fee S <br />'cf0 <br />Install Sewer Hookup: <br />Fee S <br />State Surtax: <br />Fee S <br />St <br />Total Amount Paid to Village........... <br />Fee S <br />l� `• S L <br />Signature of applicant <br />i <br />Signature of Villa QfFic' I <br />i <br />