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Village Permit N° 3867 <br />Contractor c _'. k aUX�L- Ali 141 Addres <br />Owner Address cT& "(- �;d ` <br />State License No. Village License No <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date " : J — 7kk <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: Fee S <br />Sewer Hookup: <br />Fee S <br />Install Plumbing Systems: <br />Fee S <br />Install Sewage Disposal Systems: <br />Fee S <br />Install Water Hookup: <br />Fee S <br />Install Water Supply Systems: <br />Fee S / it) <br />Imctall Sewer Hookup <br />Fee S <br />State Surtax: <br />Fee S J c <br />'total Amount Paid to Village........... <br />Fee S to 50 <br />Signature of applicant <br />Signature of Village Official <br />