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Contractor L�' <br />Owncr---.z/,, G�' t. U f/ �' J k(� yr!_ �G <br />Address <br />State License No _— Village License <br />Section No <br />Other Description: <br />Village Permit N2 2159 <br />GENERAL PERMIT <br />VILLAGE OF ORONO <br />Crystal Bay, '%Iinnmta <br />Parccl No _ <br />Plat No <br />Lot-- Block____ Subdivision <br />Date ` <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 additicnal specifications as listed below. <br />Install plumbing systems: Fee $ <br />Install <br />sewage disposal systems: Fee $— _ <br />Repair <br />Install <br />water su ply systems: Fee <br />Repo' <br />Fee <br />Total amount paid to Village....... <br />Signature of applicant <br />Signature of Village O$cial <br />j <br />