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Village Permit - - 3399 <br />Contractor Address <br />---- <br />Owner !��L. O�G'-2 Address 42..a, <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 OE ONO <br />Crystal Bay, Minnesota <br />Lot Bloom Subdi ision <br />Date /' // — 7 <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 211 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 />Signature of applicant <br />Install Sewage Disposal Systems: <br />Fee S _ <br />Install Water Hookup: <br />Fee S e d <br />(�- _ • _ �, ��- <br />Install Water Supply Systems: <br />Fee $ <br />Install Sewer Hookup: <br />Fee S <br />_J <br />Signature of Village Official <br />State Surtax: <br />Fee S —0 <br />Total Amount Paid to Village........... <br />Fee S ��_�1d�Q�(, <br />1. L�� <br />