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Village Permil N" 1275 <br />Contractor r 6 r1' z o •1 — �a 6 W f Address—_ / ! t0 rI �a <br />Owner—_L x v I f- P flE Address e S S pe- <br />State License No <br />Section No <br />Other Description: <br />Village License <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Datob <br />Parcel No. <br />L,ot Block Subdivision <br />Plat No <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 blow. <br />Install plumbing systems: <br />Install <br />sewage disposal systems: <br />Rr%Mp <br />water supply systems: <br />Repair <br />Fee $ <br />Fee $ <br />Fee$ /O••O <br />Fee $_ <br />Total amount paid to Village........ $/ �'—()-- <br />Signature of applicant <br />Signature of Village Official <br />