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rc� <br />Village Permit No 603 <br />Con tractor 19ZrI-0� Address <br />Owner Address- /22101i-�z <br />State License No Village License No <br />GENERAL PERMIT <br />VILLAGE OF OAONO <br />Crystal Bay, Minnesota <br />Date. <br />F/ 3 / 04 <br />/ 'T' 4 <br />Plat No <br />Section No c� ,o Parcel No— LiOi�-- Bloc Subdivisi•+ G <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 />Install plumbing systems: Fee $ <br />Install <br />sewage disposal systems: Fee $ <br />s' <br />Install water supply systems: Fee $ <br />epw ,SO <br />L�0 Fee $7 d <br />Total amount paid to Village....... $� <br />Signature of applicant <br />Signature of Village Official <br />