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Village Permit <br />Address <br />Address �J J �' d ) f� <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date <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 specifications as listed below. <br />Water Meter: <br />Sewer Hookup: <br />Install Plumbing Systems: <br />Install Sewage Disposal Systems <br />Install Water Hookup: <br />Fee S <br />Fee S ff <br />Fee S <br />Fee S <br />Fee S <br />Install Water Supply Systems: Fee S <br />Install Sewer Hookup: Fee S <br />State Surtax: Fee S C- <br />Total Amount Paid to Village........... Fee S /C -�4, <br />Signature of applicant <br />Signature of Village Offici; <br />`fin, � �: - , <br />