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I.Village Perm.it <br />3316 <br />:a <br />Contractor V L x( a Address <br />Owner-- +fl-x-�L[I l� l.L�'-)P�t- ��<1_�� at, <br />Address - TYY3 <br />V4t;e. 3Too %ieuvp <br />' Stat't+ License No. — Village License No — <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, \linnesota <br />Date <br />Parcel No, <br />Section No. Lot— Block Subdivision <br />Plat No _ <br />Other Description: <br />r <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 />l <br />.` comply with the Village Code of Orono applicable thereto, and shall include al) additional specifications as listed below. <br />Install plunging- systems: Fee <br />,install <br />sewage di9pess Fee $ <br />Repair <br />t` Install <br />Repair water supply systems: Fee $—_ <br />Fee $ .. <br />4 Total amount paid to Village....... <br />Signature of applicant <br />Signature of Village Official <br />