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Vine. Pwn* ::' 3644 <br />Conhactor Address <br />Owner AddressZzkLd <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date �—/ f% — 7,g- <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, 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 speci6ations as listed below. <br />Water Meter: <br />Fee S <br />Sewer Hookup: <br />Feet �Q• <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Install Water Hookup: <br />Install Water Supply Systems: <br />Install Sewer Hookup: <br />Fee $ Signature of applicant <br />Fee S <br />Fee SQ� <br />Fee S <br />State Surtax: Fee S ' <br />Total Amount Paid to Village........... Fee S <br />Signature of Village Official <br />Z <br />��i e <br />