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Contractor--�!=(�' <br />Owner_�G �. (` ,"i �T/Yj•A . Cwt/ <br />State License No. <br />Village Permit N° 2438 <br />n / <br />h, <br />Address <br />Village License No— <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />Date <br />Parcel No <br />Section No Lot_ Block Subdivisi <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 />Install plumbing systems: Fee <br />Install <br />_sewage disposal systems: Fee $ r ' <br />&P61- <br />Install <br />water supply systems: Fee $ <br />Repair <br />--- – – --- -- Fee $ <br />Total amount paid to Village....... <br />Signature of applicant <br />Signature of \'iYage Official <br />//t 1 /I Y /� <br />