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Village Permit 1 3057
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Contractor �Q •u-r» '- ��t � Address
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Owner^� Address
State License No
Village License
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesot.,
Date
Parcel No
Section No Lot Block Subdivision
Plat No
Other Description:
I hereby agree that, in case a permit is granted, all work which shall be done and a;l materials which shall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed below.
Install plumbing systems: Fee $
Install
sewage disposal systems: Fee $
Repair
Install
water supply system&#- Fee $
Repair
_ Fee $ it
Total a count paid to Village....... $ v
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Signature of applicant
Signature of Village Official