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Village Permit N° 3894 <br />� r <br />Contractor - Q Address <br />Owner. "--a'�'r'r I1.N/3 a �t�� Address <br />State License No <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Lot Block Subdivision <br />Date / I — 1 k <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 Ml eter: Fee S <br />Sewer Hookup: Fee S <br />Install Plumbing Syst—ns: Fee S <br />Install Sewage Disposal Systems: Fee S <br />Install Water Hookup: Fee S <br />Install Water Supply Systems: fee S <br />Signature of applicant <br />Install Sewer Hookup: Fee S 1(0,6 J <br />J Signature of Village Official <br />State Surtax: Fee S / [ /� <br />Total Amount Paid to Village. .. ... Fce S r /` �� <br />