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Village Permit N9 1159 <br />Contractor /'� - - --- -Address ( <br />Owner --IX Address <br />'1. -- <br />State License No.—___ ___ Village License No.—__ ___ <br />Parcel No. <br />Section No <br />Plat No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Irate �` r4 <br />Lot Bloch-- Subdivision—_—_________ _ _- _ <br />I hereby agree that, in case a permit is granted, all work which shall be done and ail materials which shall be used, slull <br />comply with the Village Code of Orono applicable thereto, and shall include all additional specification; as listed below. <br />Instill plumbing systems: <br />Fee—_______ <br />Install <br />disposal <br />( <br />sewage systems: <br />Fee $— <br />Install <br />water supply systems: <br />Repair <br />Fee $ - <br />- - --- - ----- <br />Fee -- <br />Total amount paid to \ illagc........ <br />Signature of applicant <br />Siguaturc of Village Official <br />