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VAag* Pirmit - 3369 <br />. - A <br />ContactoiL <br />\ A Ownex-^ Jj. (_ ) if '/ (/ £ )iy4\^€*\ ‘ <br />Address. <br />Address. <br />Stale License No-Vdiage License No. <br />GENERAL PERMIT <br />VILLAGE or OnONO <br />Crystal Bay, Minnesota <br />Section No. <br />Parcel No. <br />Pht No- <br />Subdivision. <br />Other Description: <br />I hereby agree that, in case a permit is granted, all work which shall be done and all matcriab which shall be used, shall <br />comply with tlie Village Code of Orono applicable thcrehx and shall include all additional specifications as luted bdow. <br />■X -2 -2 L 9-v ’T3________________________ <br />1 eo <br />Water Meter Fees <br />Sewer Hookup:Fees <br />Install Plumbing Systems:Fees <br />Install Sewage Disposal Systems:Fees <br />Install Water Hookup:Fee S <br />Install Water Supply Systems:Fee $ <br />Install Sewer Hookup:Fee S <br />State Surtax:Foe $ <br />Total Amount Paid to Village ....................Fee S <br />Signature of apjdicant <br />p r^k( ( Lk^ <br />cSignature of Village Official <br />1