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a9. p Al3850 <br />Contractor a A—.,� Address <br />Owner -{- el ,/ ' o kliE} ov/ Address h4o ,-1 <br />✓ 3 iZo - e�oo �io�ti� <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date <br />( <br />Parcel No. <br />Section No Lot Block Subdivision <br />Plat No <br />Other Description: <br />I hereby agree that, in case a permit is granted, 211 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 />Install Sewer Hookup: <br />Fee S <br />�Q <br />State Surtax: <br />Fee S <br />Total Amount Paid to Village.. ........ <br />Fee S <br />lL <br />Signature of applicant <br />Signature of Village 06reial <br />Lh t <br />