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Village Permit IN . 454.5 <br />Contractor Address— _ <br />Owner 1. k:' X /9) cttr Address <br />State License No. Village License No.— <br />' ENERAL PERMIT <br />Parcel No..___. _ <br />Section No <br />Plat No.—_ <br />Other Description: <br />VILLAGE OF ORONO <br />Crustal Rat, %1nuu•tiota <br />Lot_ Block__ <br />Dates <br />Subdivision _ <br />I hcreb%• agree that, in case a permit is granted, all <br />work which <br />shall <br />be done <br />and all materials which shall <br />be used, shall <br />(ontph' with the Village <br />Code of Orono applicable <br />thereto, and <br />shall <br />include <br />all additional specifications as <br />listed below. <br />Wrtcr Meter Fee S <br />Sewer Ifixrkup Fre S <br />IndJll Plumhinit Syorme. Fee S _ <br />Syure of applicant <br />1110,41111 1�'MJ#I' 11HpVwl PIySICm6 Fee f �rwt'" <br />7 ' <br />InNIA1 WAlo Ifookup Fm S <br />4 IL <br />Indall Water Supply Ss oclr+. Fee S <br />Imtall firwcr Nix)kup Fee S <br />Signature Of %,AW,O4LW <br />%talc Surta• For S <br />11141 Anf+.unl Pard III S, 111a{i For { <br />y� <br />