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Village Permit
Address— 1� '.'' clie /�'lF
Address r Cj I�r
State License No._ Village License No --
Parcel No.
Section No
Plat No.
Uti sr Description:
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date
Lot_ Bloch Subdivision—
I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
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Install plumbing systems: Fee
Install r
sewage diMxv,*1 wstesw: Fee $
Repuir
e
Install
water supply r4s0n: Fee $ Ir C
Itepuir
Total amounntt paid to Village .......
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Signature of applicant
Signature of Village Official