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Village Permit N? _ 4131 <br />/tr yeti �'= '2' Address '-_ z Y, ' <br />Contractor,/ -- s ���—/ �—, �r <br />Owner � �—. 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 />Dat <br />]rot Block Subdivision <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 />Sewer Hookup: <br />!rtstall Plumbing Systems: <br />Install Sewage Disposal Systems: <br />Install Water Hookup: <br />Install Water Supply Systems: <br />Install Sewer Hookup: <br />State Surtax: <br />Fee S <br />Fee S <br />Fee S <br />Fee S <br />o� <br />Fee $ C' _ <br />Fee S <br />Fee S <br />Fee S <br />Total Amount Paid to Village........... Fee S+ <br />Signature of applicant <br />Signature of Village Official <br />121 ;;:-" ��,/ <br />