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Village Permit N° 3923 <br />C <br />Contractor Addr ' B <br />�-rn ate-- l(fc�-L <br />Owner. Address <br />Statc License 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 Subdivision <br />Date 5- ,94-74 <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: 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 / O <br />Install Sewer Hookup: <br />Fee S <br />State Surtax: <br />hh <br />Fee S ✓ Q <br />Total Amount Paid to Village........... <br />Fee S O ' <br />Signature of applicant <br />Signature of Village 06cial <br />�Nx-4A&It- <br />