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W <br />Address <br />// I, / i l e- At A <br />State License No. r — Village License No. <br />r �.�I iia S <br />Section No <br />Other Description: <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Parcel No. --- <br />Plat No - <br />Lot -- <br />o <br />Lot—.— Block_ Subdivision <br />Village Permit N2 <br />Da to <br />1069 <br />I hereby agree that, in case a permit is granted, all <br />work which shall be done <br />and <br />all materials which shall be used, shall <br />comply with the Village <br />Code of Orono applicable <br />thereto, and shall include <br />all <br />additional specifications as listed below. <br />Install plumbing systems: Fee <br />Install <br />sewage disposal systems: Fee $ <br />Repair <br />Install <br />water supply systems: Fee $ - <br />Repair - <br />_ Fee $ <br />otal amount paid to Villagc....... $ <br />Signature of applicant <br />Signature of Village Official <br />